FORM 1023-EZ for LAVERNE FOOD PANTRY ASSOCIATION

Field Data
EIN 86-3609623
Case Number EO-2021130-000098
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LAVERNE FOOD PANTRY ASSOCIATION
Organization’s Mailing Address PO BOX 1
City MAY
State OK
ZIP 73851
Accounting period End 12
Primary contact name LORI TURNER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KARL JETT
CHAIRMAN OF THE BOARD
158524 EW 28 RD
LAVERNE OK 73848

Officer/Director/Trustee Two

LORI TURNER
SECRETARY TREASURER
182171 E COUNTY RD 34
MAY OK 73851

Officer/Director/Trustee Three

LISA BROOKS
DIRECTOR
803 W OKLAHOMA DRIVE
LAVERNE OK 73848

Officer/Director/Trustee Four

KURT LONG
DIRECTOR
502 S OHIO
LAVERNE OK 73848

Officer/Director/Trustee Five

LANCE GIBSON
DIRECTOR
17987 E 18 RD
LAVERNE OK 73848

Organization’s website
Organization’s email ASLORITURNS48@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/26/2021
Organization Incorporation State OK
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 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 LORI TURNER
Signature Title SECRETARY TREASURER
Signature Date 5/6/2021

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