FORM 1023-EZ for KIDS 1ST DISABILITY RESOURCE CENTER

Field Data
EIN 47-5333172
Case Number EO-2016102-000053
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KIDS 1ST DISABILITY RESOURCE CENTER
Organization’s Mailing Address P O BOX 122
City ORRVILLE
State AL
ZIP 36767
Accounting period End 12
Primary contact name KAREN PETTAWAY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KAREN PETTAWAY
EXECUTIVE DIRECTOR
P O BOX 122
ORRVILLE AL 36767

Officer/Director/Trustee Two

DONNA ALLEN
PRESIDENT/VICE PRESIDENT
305 COUNTY ROAD 315
MARION JCT AL 36759

Officer/Director/Trustee Three

DEBORAH VOLTZ
SECRETARY
185 COUNTY ROAD 911
ORRVILLE AL 36767

Officer/Director/Trustee Four

RENA JONES
TREASURER
1676 COUNTY ROAD 949
ORRVILLE AL 36767

Organization’s website
Organization’s email KARENPETTAWAY@CENTURYTEL.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/16/2012
Organization Incorporation State AL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P82 - Developmentally Disabled Centers, Services
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 Yes
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
Signature Title
Signature Date

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