FORM 1023-EZ for HK BACKPACK PROGRAM

Field Data
EIN 81-5450853
Case Number EO-2017242-000276
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HK BACKPACK PROGRAM
Organization’s Mailing Address 46 ALDERS BRIDGE RD
City KILLINGWORTH
State CT
ZIP 06419
Accounting period End 12
Primary contact name AMBER STAMM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

AMBER STAMM
PRESIDENT/DIRECTOR
46 ALDERS BRIDGE RD
KILLINGWORTH CT 06419

Officer/Director/Trustee Two

WILLIAM STAMM
OFFICER
46 ALDERS BRIDGE RD
KILLINGWORTH CT 06419

Officer/Director/Trustee Three

TORREY MACDONALD
OFFICER
116 DUBLIN HILL RD
HIGGANUM CT 06441

Organization’s website
Organization’s email HKBACKPACKPROGRAM@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/23/2017
Organization Incorporation State CT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K30 - Food Service, Free Food Distribution Programs
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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