FORM 1023-EZ for KIWANIS CLUB OF LAGUNA-ELK GROVE FOUNDATION

Field Data
EIN 81-4611655
Case Number EO-2017003-000307
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KIWANIS CLUB OF LAGUNA-ELK GROVE FOUNDATION
Organization’s Mailing Address PO BOX 581201
City ELK GROVE
State CA
ZIP 95758-1201
Accounting period End 9
Primary contact name PAULA BUSSEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KIRSTEN IRETON
PRESIDENT
6000 BROCKENHURST DRIVE
ELK GROVE CA 95758-6232

Officer/Director/Trustee Two

PAULA BUSSEY
TREASURER
9005 CROWLEY WAY
ELK GROVE CA 95624-3113

Officer/Director/Trustee Three

LORIE DEERING
DIRECTOR
6021 IVY SPRING COURT
ELK GROVE CA 95758-6232

Officer/Director/Trustee Four

JOHN DEERING
DIRECTOR
6021 IVY SPRING COURT
ELK GROVE CA 95758-6232

Officer/Director/Trustee Five

RITA GERMAIN
SECRETARY
6108 WILD FOX COURT
ELK GROVE CA 95757-8336

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/23/2016
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T50 - Philanthropy, Charity, Voluntarism Promotion, General
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 Yes
Conducting Activities Outside of United States Yes
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 No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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