FORM 1023-EZ for KIWANIS CLUB OF KIRKSVILLE FOUNDATION

Field Data
EIN 47-2308711
Case Number EO-2014351-000086
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KIWANIS CLUB OF KIRKSVILLE FOUNDATION
Organization’s Mailing Address 20304 STATE HIGHWAY 157
City KIRKSVILLE
State MO
ZIP 63501
Accounting period End 9
Primary contact name BRENT STEACY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CAROLYN CHRISMAN
PRESIDENT
28934 STATE HIGHWAY 6
KIRKSVILLE MO 63501

Officer/Director/Trustee Two

MANDY WIEDEMAN
PRESIDENT ELECT
1508 KINGS ROAD
KIRKSVILLE MO 63501

Officer/Director/Trustee Three

FELIX ADLER
VICE PRESIDENT
23075 RAINBOW BASIN TRAIL
KIRKSVILLE MO 63501

Officer/Director/Trustee Four

BRENT STEACY
TREASURER
20304 STATE HIGHWAY 157
KIRKSVILLE MO 63501

Officer/Director/Trustee Five

JOHN BUCKWALTER
SECRETARY
2602 NORTH NEW
KIRKSVILLE MO 63501

Organization’s website
Organization’s email KIRKSVILLEKIWANIS@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/18/2014
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O12 - Fund Raising and/or Fund Distribution
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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