FORM 1023-EZ for TABLE OF GRACE MOBILE FOOD PANTRY INC

Field Data
EIN 46-5512548
Case Number EO-2015331-000129
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TABLE OF GRACE MOBILE FOOD PANTRY INC
Organization’s Mailing Address 11198 RD 19A
City SIDNEY
State NE
ZIP 69162
Accounting period End 12
Primary contact name KIM CASTNER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TIMM LINDEMAN
DIRECTOR
2426 DEAVER DR
SIDNEY NE 69162

Officer/Director/Trustee Two

KIMBERLY CASTNER
DIRECTOR
2308 LINDEN
SIDNEY NE 69162

Officer/Director/Trustee Three

DEBORAH AIKENS
DIRECTOR
11198 RD 19A
SIDNEY NE 69162

Organization’s website N/A
Organization’s email HTLCDEB@MSN.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/7/2014
Organization Incorporation State NE
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 Yes
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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