FORM 1023-EZ for FARLEYS FUND

Field Data
EIN 47-4565654
Case Number EO-2015251-000326
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FARLEYS FUND
Organization’s Mailing Address 450 FLIER DR
City PACIFIC
State MO
ZIP 63069
Accounting period End 12
Primary contact name AMBER WAGNER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

AMBER WAGNER
DIRECTOR
1615 BIRCH
PACIFIC MO 63069

Officer/Director/Trustee Two

ASHLEY HILL
BOARD MEMBER
917 THORNTON
PACIFIC MO 63069

Officer/Director/Trustee Three

VALERIE TAYLOR
BOARD MEMBER
4539 NANNY GOAT
CATAWISSA MO 63015

Officer/Director/Trustee Four

CAMERON TOBEY
BOARD MEMBER
191 DUNN RD
CATAWISSA MO 63015

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/6/2015
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N20 - Recreational and Sporting Camps
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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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