FORM 1023-EZ for DEEJAY JORDAN 5 MEMORIAL TRUST

Field Data
EIN 81-3012276
Case Number EO-2016204-000081
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DEEJAY JORDAN 5 MEMORIAL TRUST
Organization’s Mailing Address 213 CRAZY J FARM LN
City VANCEBURG
State KY
ZIP 41179
Accounting period End 6
Primary contact name KARINA JORDAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KARINA JORDAN
PRESIDENT/TRUSTEE
213 CRAZY J FARM LN
VANCEBURG KY 41179

Officer/Director/Trustee Two

ROBERT JORDAN
TRUSTEE
213 CRAZY J FARM LN
VANCEBURG KY 41179

Officer/Director/Trustee Three

DALTON JORDAN
TRUSTEE
213 CRAZY J FARM LN
VANCEBURG KY 41179

Officer/Director/Trustee Four

MARK JORDAN
TRUSTEE
1366 JACKS CREEK RD
RICHMOND KY 40475

Officer/Director/Trustee Five

MATT JORDAN
VICE-PRESIDENT/TRUSTEE
1383 BLUE SPRINGS BRANCH RD
VANCEBURG KY 41179

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/10/2016
Organization Incorporation State KY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O12 - Fund Raising and/or Fund Distribution
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 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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