FORM 1023-EZ for THE COMMUNITY BASKET

Field Data
EIN 46-1417017
Case Number EO-2016315-000291
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE COMMUNITY BASKET
Organization’s Mailing Address 326 MAIN STREET
City MOVILLE
State IA
ZIP 51039
Accounting period End 12
Primary contact name DEBORAH CLARK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DARRELL WALDNER
PRESIDENT
P O BOX 623
KINGSLEY IA 51028

Officer/Director/Trustee Two

EMILY THOMAS
VICE PRESIDENT
319 FAIR STREET
MOVILLE IA 51039

Officer/Director/Trustee Three

KATHY MYRES
SECRETARY
625 JACKSON STREET
MOVILLE IA 51039

Officer/Director/Trustee Four

DEBORAH CLARK
TREASURER
P O BOX 113
MOVILLE IA 51039

Officer/Director/Trustee Five

RANDY PETERSEN
BOARD MEMBER
1621 EASTLAND AVENUE
LAWTON IA 51030

Organization’s website WWW.COMMUNITYBASKET.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/1/2015
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K31 - Food Banks, Food Pantries
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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