FORM 1023-EZ for KC HEALTH INITIATIVE
| Field | Data |
|---|---|
| EIN | 84-4115425 |
| Case Number | EO-2020160-000232 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | KC HEALTH INITIATIVE |
| Organization’s Mailing Address | 1103 WESTPORT ROAD |
| City | KANSAS CITY |
| State | MO |
| ZIP | 64111-4041 |
| Accounting period End | 12 |
| Primary contact name | GIGI JONES |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
CHARLES CLARK
TREASURER
2101 VINE ST APT 405
KANSAS CITY MO 64108-3150
Officer/Director/Trustee Two
MARDO JOHNSON
DIRECTOR
1700 EVERGREEN ST
LEAVENWORTH KS 66048-4014
Officer/Director/Trustee Three
DARRIOIN CLARK
VICE PRESIDENT
4741 CENTRAL APT 231
KANSAS CITY MO 64112-1533
Officer/Director/Trustee Four
DIANE WALLACE
SECRETARY
832 SILVERPEAK
SHERWOOD AR 72120-2361
Officer/Director/Trustee Five
GIGI JONES
PRESIDENT
1103 WESTPORT ROAD
KANSAS CITY MO 64111-4041
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 10/4/2019 |
| Organization Incorporation State | MO |
| 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 | 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 | GIGI JONES |
| Signature Title | PRESIDENT |
| Signature Date | 6/4/2020 |
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