FORM 1023-EZ for KIWANIS CLUB OF CLAYTON NC CHARITABLE FOUNDATION

Field Data
EIN 85-4360938
Case Number EO-2021035-000087
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KIWANIS CLUB OF CLAYTON NC CHARITABLE FOUNDATION
Organization’s Mailing Address 156 WEBFOOT DRIVE
City GARNER
State NC
ZIP 27529
Accounting period End 9
Primary contact name THOMAS BERNARD HERRING
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANAND SRINIVASAN
PRESIDENT
156 WEBFOOT DRIVE
GARNER NC 27529

Officer/Director/Trustee Two

DARBY CREECH
VICE-PRESIDENT
153 NEUSE LANDING DRIVE
CLAYTON NC 27527

Officer/Director/Trustee Three

THOMAS HERRING
TREASURER
409 HOGAN CIRCLE
CLAYTON NC 27527

Officer/Director/Trustee Four

MICHAEL DAWKINS
SECRETARY
63 CRABAPPLE LANE
CLAYTON NC 27527

Officer/Director/Trustee Five

DONALD MOSES
DIRECTOR
117 OLD EVANS ROAD
GARNER NC 27529

Organization’s website
Organization’s email ANDYSRINIVASAN@JOHNSTON.K12.NC.US
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/2/2020
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T30 - Public Foundations
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ANAND SRINIVASAN
Signature Title PRESIDENT
Signature Date 12/21/2020

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