FORM 1023-EZ for HEAVENS MANNA FOOD PANTRY

Field Data
EIN 84-3533845
Case Number EO-2019322-000468
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HEAVENS MANNA FOOD PANTRY
Organization’s Mailing Address 42 FIFTH STREET
City ROXIE
State MS
ZIP 39661
Accounting period End 12
Primary contact name AMELIA PILGRIM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARSHA DAVIS
VICE PRESIDENT/SECRETARY
1288 NEW SALEM ROAD
MCCALL CREEK MS 39647

Officer/Director/Trustee Two

AMELIA PILGRIM
FOUNDER/PRESIDENT
42 FIFTH STREET
ROXIE MS 39661

Officer/Director/Trustee Three

BARBARA SHARP
DIRECTOR
561 GARDEN CITY ROAD
ROXIE MS 39661

Officer/Director/Trustee Four

TAYLOR DAVIS WALLACE
DIRECTOR
520 CURAN AVENUE
BROOKHAVEN MS 39601

Organization’s website
Organization’s email GLASSBTTERFLY@AOL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/20/2017
Organization Incorporation State MS
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: Yes
Educational: Yes
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 Yes
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 AMELIA PILGRIM
Signature Title FOUNDER/PRESIDENT
Signature Date 11/15/2019

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