FORM 1023-EZ for KIWANIS OF PASCO HERNANDO FOUNDATION INC

Field Data
EIN 85-1385010
Case Number EO-2020196-000237
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KIWANIS OF PASCO HERNANDO FOUNDATION INC
Organization’s Mailing Address 16313 SACRAMENTO AVENUE
City BROOKSVILLE
State FL
ZIP 34604
Accounting period End 9
Primary contact name LILLIAN CHARLENE KENYON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID BROWN
PRESIDENT
16313 SACRAMENTO AVENUE
BROOKSVILLE FL 34604

Officer/Director/Trustee Two

WALTER HAWKINS
TREASURER
5018 BREAKWATER BLVD
SPRING HILL FL 34607

Officer/Director/Trustee Three

KATHY BROWN
SECRETARY
16313 SACRAMENTO AVENUE
BROOKSVILLE FL 34604

Officer/Director/Trustee Four

ADAM HAYNES
DIRECTOR
8540 BAY DRIVE
SPRING HILL FL 34606

Officer/Director/Trustee Five

LILLIAN KENYON
DIRECTOR
10312 AUTUMNWOOD DRIVE
HUDSON FL 34667

Organization’s website
Organization’s email KIWANISOFPASCOHERNANDO@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/9/2020
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S80 - Community Service Clubs
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: Yes
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 LILLIAN KENYON
Signature Title DIRECTOR
Signature Date 6/11/2020

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