FORM 1023-EZ for GRANDPAS POCKET INC

Field Data
EIN 45-3011919
Case Number EO-2014245-000359
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name GRANDPAS POCKET INC
Organization’s Mailing Address 3417 BLINE AVENUE
City BELLEVUE
State NE
ZIP 68123
Accounting period End 12
Primary contact name JOHNNIE ANDERSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JOHNNIE R ANDERSON
PRESIDENT
3417 BLINE AVE
BELLEVUE NE 68123

Officer/Director/Trustee Two

JESSIE PARSONS
SECRETARY/TREASURER
14645 PAWNEE ROAD
BENNINGTON NE 68007

Officer/Director/Trustee Three

KEITH DE FINI
DIRECTOR
6117 SOUTH 195TH STREET
OMAHA NE 68135

Officer/Director/Trustee Four

TERESA HAMILTON
DIRECTOR
904 EDGEWATER DRIVE
PAPILLION NE 68046

Officer/Director/Trustee Five

KENNETH KAMINSKI
DIRECTOR
4553 PIERCE STREET
OMAHA NE 68106

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/18/2011
Organization Incorporation State NE
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P42 - Single Parent Agencies, Services
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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