FORM 1023-EZ for EMPIRE FOUNDATION INC

Field Data
EIN 84-3606191
Case Number EO-2019312-000175
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name EMPIRE FOUNDATION INC
Organization’s Mailing Address 3524 ALCOA ROAD
City BENTON
State AR
ZIP 72015
Accounting period End 12
Primary contact name LISA WEEKS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BROOKE PLACK
EXECUTIVE DIRECTOR
3524 ALCOA RD
BENTON AR 72015

Officer/Director/Trustee Two

LISA WEEKS
GRANT WRITER
4124 LONESOME OAK LOOP
HENSLEY AR 72065

Officer/Director/Trustee Three

ROBERT BATES
PROGRAM EVALUATOR
503 S 1ST STREET
BENTON AR 72015

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/6/19
Organization Incorporation State AR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 Yes
Donation of funds No
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 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 BROOKE PLACK
Signature Title EXECUTIVE DIRECTOR
Signature Date 11/6/19

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