FORM 1023-EZ for KINGDOM KOFFEE INC

Field Data
EIN 81-3357539
Case Number EO-2016340-000279
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KINGDOM KOFFEE INC
Organization’s Mailing Address 627 PALM AVE
City MODESTO
State CA
ZIP 95350
Accounting period End 12
Primary contact name PIERCE WESTFALL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PIERCE WESTFALL
PRESIDENT
627 PALM AVE
MODESTO CA 95350

Officer/Director/Trustee Two

DIANA WESTFALL
DIRECTOR
627 PALM AVE
MODESTO CA 95350

Officer/Director/Trustee Three

EVAN ELLIOTT
SECRETARY
1625 RICHLAND AVE APT 123
CERES CA 95307

Officer/Director/Trustee Four

GABRIEL PICKER
TREASURER
5408 INDIAN RIDGE LN
SALIDA CA 95368

Organization’s website WWW.KINGDOMKOFFEE.ORG
Organization’s email INFO@KINGDOMKOFFEE.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/13/2016
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
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 Yes
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance Yes
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
Signature Title
Signature Date

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