FORM 1023-EZ for THE MACK FOUNDATION INC

Field Data
EIN 47-4440538
Case Number EO-2015205-000510
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE MACK FOUNDATION INC
Organization’s Mailing Address 328 KELLI ROSE WAY
City LEXINGTON
State KY
ZIP 40514
Accounting period End 12
Primary contact name CASEY KELLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SHELVIN MACK JR
PRESIDENT, EXECUTIVE DIRECTOR
328 KELLI ROSE WAY
LEXINGTON KY 40514

Officer/Director/Trustee Two

BETTY QUISENBERRY
TREASURER, DIRECTOR
129 GORMLEY DRIVE
VERSAILLES KY 40383

Officer/Director/Trustee Three

VICTORIA GUY
VICE PRESIDENT, DIRECTOR
328 KELLI ROSE WAY
LEXINGTON KY 40514

Officer/Director/Trustee Four

TYANE BROWN
SECRETARY, DIRECTOR
128 LANDINGS DRIVE APT 24
FRANKFORT KY 40601

Officer/Director/Trustee Five

DEANDRE ADAMS
DIRECTOR
1531 GRANT DRIVE
LEXINGTON KY 40511

Organization’s website
Organization’s email THEMACKFOUNDATIONKY@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/26/2015
Organization Incorporation State KY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (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 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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