FORM 1023-EZ for AMEN PLACE SOUP KITCHEN INC

Field Data
EIN 32-0283410
Case Number EO-2018318-000384
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name AMEN PLACE SOUP KITCHEN INC
Organization’s Mailing Address 105 GUY PARK AVE
City AMSTERDAM
State NY
ZIP 12010-1912
Accounting period End 12
Primary contact name KARL ANDRZEJCZYK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHRISTINE ANDRZEJCZYK
CHIEF EXECUTIVE OFFICER
477 LOCUST AVE
AMSTERDAM NY 12010-1912

Officer/Director/Trustee Two

KARL ANDRZEJCZYK
PRESIDENT
477 LOCUST AVE
AMSTERDAM NY 12010-1912

Officer/Director/Trustee Three

KATHY BOLGER
VICE PRESIDENT
498 W FULTON STREET EXT
GLOVERSVILLE NY 12078

Officer/Director/Trustee Four

MAUREEN YOUNG
TRESURER
CRANES HOLLOW RD
AMSTERDAM NY 12010

Officer/Director/Trustee Five

CRAIG LANGE
SECRETARY
153 N TOLL ST
SCOTIA NY 12302

Organization’s website
Organization’s email KFERNWOOD@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/22/18
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K35 - Eatery, Agency, Organization Sponsored
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 KARL ANDRZEJCZYK
Signature Title PRESIDENT
Signature Date 11/12/18

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