FORM 1023-EZ for OPEN HEART FOOD BANK

Field Data
EIN 83-4568318
Case Number EO-2019121-000217
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name OPEN HEART FOOD BANK
Organization’s Mailing Address 109 MAPLE ST
City SOUTH PEKIN
State IL
ZIP 61564
Accounting period End 12
Primary contact name AMY LAMBERON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

AMY LAMBERSON
PRESIDENT
PO BOX 512
SOUTH PEKIN IL 61564

Officer/Director/Trustee Two

JOYCE DEBOER
VP
13755 JUBILEE DR
PEKIN IL 61554-8017

Officer/Director/Trustee Three

TALENA MICHELS
TREASURER
1301 HAWTHORNE AVE
PEKIN IL 61554

Officer/Director/Trustee Four

KIM WATSON
TRUSTEE
PO BOX15
SOUTH PEKIN IL 61564

Organization’s website
Organization’s email ALAMBERSON@OUTLOOK.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/29/19
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K19 - Nonmonetary Support N.E.C.
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 No
Correctness Declaration Yes
Signature Name AMY LAMBERSON
Signature Title PRESIDENT
Signature Date 4/29/19

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