FORM 1023-EZ for WATER INTO WINE FOOD PANTRY

Field Data
EIN 46-5166435
Case Number EO-2017184-000155
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name WATER INTO WINE FOOD PANTRY
Organization’s Mailing Address 5083 MIDDLE FORK RD SUITE B
City SALYERSVILLE
State KY
ZIP 41465
Accounting period End 1
Primary contact name SARAH PATRICK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GARTH RISNER
PRESIDENT
6635 MIDDLE FRK RD
SALYERSVILLE KY 41465

Officer/Director/Trustee Two

SARAH PATRICK
VICE PRESIDENT
HC 61 BOX 86-C
SALYERSVILLE KY 41465

Officer/Director/Trustee Three

VALERIE INZER
DIRECTOR OF DISTRIBUTION
5163 MIDDLE FRK RD
SALYERSVILLE KY 41465

Officer/Director/Trustee Four

JENNIFER MINIX
SECRETARY
1102 OAKLEY FORK
SALYERSVILLE KY 41465

Officer/Director/Trustee Five

VICKIE FLETCHER
TREASURER
723 HOWARD BR
SALYERSVILLE KY 41465

Organization’s website WWW.WATERINTOWINEFOODPANTRY.WEEBLY.COM
Organization’s email LAKEFRONTCHURCHOFGOD@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/2013
Organization Incorporation State KY
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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