FORM 1023-EZ for HALEYVILLE COMMUNITY FOUNDATION

Field Data
EIN 45-0542197
Case Number EO-2016231-000426
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HALEYVILLE COMMUNITY FOUNDATION
Organization’s Mailing Address P O BOX 634
City HALEYVILLE
State AL
ZIP 35565
Accounting period End 12
Primary contact name JONATHAN BENNETT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

J SHANE COOK
DIRECTOR
1200 21ST STREET
HALEYVILLE AL 35565

Officer/Director/Trustee Two

JONATHAN BENNETT
DIRECTOR
3622 LITTLEVILLE ROAD
HALEYVILLE AL 35565

Officer/Director/Trustee Three

BOBBY TAYLOR
DIRECTOR
825 20TH STREET
HALEYVILLE AL 35565

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/12/2006
Organization Incorporation State AL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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