FORM 1023-EZ for KEN BRINDLEY MEMORIAL FOUNDATION WISE WATER SAFE SWIMMER

Field Data
EIN 84-2103343
Case Number EO-2019176-000349
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KEN BRINDLEY MEMORIAL FOUNDATION WISE WATER SAFE SWIMMER
Organization’s Mailing Address 1235 SALEM ROAD
City CONWAY
State AR
ZIP 72034
Accounting period End 12
Primary contact name MELANIE BRINDLEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MELANIE BRINDLEY
PRESIDENT
1235 SALEM RD
CONWAY AR 72034

Officer/Director/Trustee Two

DOT WELCH
VICE PRESIDENT
1235 SALEM RD
CONWAY AR 72034

Officer/Director/Trustee Three

BRIAN WESTFALL
SECRETARY
1235 SALEM RD
CONWAY AR 72034

Officer/Director/Trustee Four

TOMMY COX
AGENT
1235 SALEM RD
CONWAY AR 72034

Officer/Director/Trustee Five

ORA LYNN BLACKWELL
TREASURER
1235 SALEM RD
CONWAY AR 72034

Organization’s website SWIMSAFETY.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/30/19
Organization Incorporation State AR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: Yes
Religious: No
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 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 MELANIE BRINDLEY
Signature Title PRESIDENT
Signature Date 6/21/19

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