FORM 1023-EZ for BELLEVILLE KIWANIS CHARITIES FOUNDATION

Field Data
EIN 47-1605843
Case Number EO-2014279-000500
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BELLEVILLE KIWANIS CHARITIES FOUNDATION
Organization’s Mailing Address PO BOX 153
City BELLEVILLE
State IL
ZIP 62222
Accounting period End 12
Primary contact name GARY W HEATH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

PATRICIA THOMAS
PRESIDENT
42 COUNTRY CLUB ACRES
BELLEVILLE IL 62223

Officer/Director/Trustee Two

TOM TEBBENOFF
VICE PRESIDENT
807 N STATE ST
FREEBURG IL 62243

Officer/Director/Trustee Three

GARY HEATH
SECRETARY
710 N KEEBLER AVE
COLLINSVILLE IL 62234

Officer/Director/Trustee Four

ALAN THOMAS
TREASURERE
42 COUNTRY CLUB ACRES
BELLEVILLE IL 62223

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/29/2013
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W12 - 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 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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