FORM 1023-EZ for BREAD FOR LIFE SENIOR PANTRY

Field Data
EIN 83-3009919
Case Number EO-2019105-000246
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BREAD FOR LIFE SENIOR PANTRY
Organization’s Mailing Address PO BOX 12771
City WILMINGTON
State NC
ZIP 28405
Accounting period End 12
Primary contact name WENDI GROSS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOE DAMITZ
PRESIDENT
PO BOX 12771
WILMINGTON NC 28405

Officer/Director/Trustee Two

ANN TREMBLAY
VICE PRESIDENT
PO BOX 12771
WILMINGTON NC 28405

Officer/Director/Trustee Three

SUSAN REILLY
SECRETARY
PO BOX 12771
WILMINGTON NC 28405

Officer/Director/Trustee Four

WENDI GROSS
EXECUTIVE CO-DIRECTOR/TREASURER
PO BOX 12771
WILMINGTON NC 28405

Officer/Director/Trustee Five

SUE KOVALESKI
EXECUTIVE CO-DIRECTOR
PO BOX 12771
WILMINGTON NC 28405

Organization’s website
Organization’s email WNDGROSS31260@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/30/18
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
Organization’s purpose Charitable: Yes
Religious: Yes
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 Yes
Donation of funds Yes
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 Yes
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 WENDI GROSS
Signature Title EXECUTIVE CO-DIRECTOR/TREASURER
Signature Date 4/11/19

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