FORM 1023-EZ for EDMONSON COUNTY SENIOR PANTRY INC

Field Data
EIN 83-3554524
Case Number EO-2019063-000113
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name EDMONSON COUNTY SENIOR PANTRY INC
Organization’s Mailing Address PO BOX 45
City BROWNSVILLE
State KY
ZIP 42210
Accounting period End 12
Primary contact name LARRY C HOWLETT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

VICKIE WALKER
PRESIDENT
4860 HWY 259 NORTH
SWEEDEN KY 42285

Officer/Director/Trustee Two

ANN BULLOCK
TREASURER
1441 MOHAWK RD
BROWNSVILLE KY 42210

Officer/Director/Trustee Three

PHONDA CLEMMONS
SECRETARY
3121 OAK HILL RD
BROWNSVILLE KY 42210

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/27/19
Organization Incorporation State KY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K30 - Food Service, Free Food Distribution Programs
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 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 VICKIE WALKER
Signature Title PRESIDENT
Signature Date 2/28/19

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