FORM 1023-EZ for KEOSAUQUA COMMUNITY FOOD BANK

Field Data
EIN 83-3841598
Case Number EO-2019205-000211
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KEOSAUQUA COMMUNITY FOOD BANK
Organization’s Mailing Address POST OFFICE BOX 341
City KEOSAUQUA
State IA
ZIP 52565-8149
Accounting period End 12
Primary contact name LONNA MCGRATH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SUSAN WASKO
PRESIDENT
708 DODGE STREET
KEOSAUQUA IA 52565

Officer/Director/Trustee Two

SHERRYL BLACKBURN
VICE PRESIDENT
22907 HIGHWAY 1
KEOSAUQUA IA 52565

Officer/Director/Trustee Three

PAM OSBORNE
TREASURER
23019 HIGHWAY 1
KEOSAUQUA IA 52565

Officer/Director/Trustee Four

PAULA BIRD
ASSISTANT TREASURER
208 MARKET STREET
KEOSAUQUA IA 52565

Officer/Director/Trustee Five

LONNA MCGRATH
SECRETARY
19276 ROUTE J40
KEOSAUQUA IA 52565

Organization’s website
Organization’s email SUSAN@WASKOHARDWARE.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/22/19
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K31 - Food Banks, Food Pantries
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name LONNA MCGRATH
Signature Title SECRETARY
Signature Date 7/21/19

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