FORM 1023-EZ for KIWANIS CLUB FOUNDATION OF PEMBROKE

Field Data
EIN 81-3195642
Case Number EO-2020009-000339
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KIWANIS CLUB FOUNDATION OF PEMBROKE
Organization’s Mailing Address 162 MOUNTAIN AVE
City PEMBROKE
State MA
ZIP 02359
Accounting period End 12
Primary contact name CHRISTINE SUCKOW
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHAEL SUCKOW
PRESIDENT
162 MOUNTAIN AVE
PEMBROKE MA 02359

Officer/Director/Trustee Two

CHRISTINE SUCKOW
TREASURER
162 MOUNTAIN AVE
PEMBROKE MA 02359

Officer/Director/Trustee Three

JAMES LEVESQUE
SECRETARY
41 HARVEST DRIVE
DUXBURY MA 02332

Officer/Director/Trustee Four

CORINNE FRANCIS
DIRECTOR
37 KINGSTON WAY
DUXBURY MA 02332

Officer/Director/Trustee Five

BEVERLY HUSSEY
DIRECTOR
83 LAKE ST
PEMBROKE MA 02359

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/14/2016
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name CHRISTINE SUCKOW
Signature Title TREASURER
Signature Date 1/7/2020
EIN 81-3195642
Case Number EO-2016217-000207
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KIWANIS CLUB FOUNDATION OF PEMBROKEINC
Organization’s Mailing Address 41 HARVEST DRIVE
City DUXBURY
State MA
ZIP 02332
Accounting period End 12
Primary contact name KELLY LE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHAEL SUCKOW
PRESIDENT
192 MOUNTAIN AVE
PEMBROKE MA 02359

Officer/Director/Trustee Two

KELLY LE
TREASURER
22 REED PLACE
WHITMAN MA 02382

Officer/Director/Trustee Three

JAMES A LEVESQUE
SECRETARY
41 HARVEST DRIVE
DUXBURY MA 02332

Officer/Director/Trustee Four

CORINNE FRANCIS
DIRECTOR
37 KINGSTOWN WAY
DUXBURY MA 02332

Officer/Director/Trustee Five

BEVERLY HUSSEY
DIRECTOR
83 LAKE STREET
PEMBROKE MA 02358

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/14/2016
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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
Signature Title
Signature Date

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