FORM 1023-EZ for AKELEY NEVIS FOOD SHELF

Field Data
EIN 27-4651169
Case Number EO-2017166-000228
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name AKELEY NEVIS FOOD SHELF
Organization’s Mailing Address P O BOX 25
City AKELEY
State MN
ZIP 56433
Accounting period End 12
Primary contact name CINDY DIETZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GEORGE LUECK
DIRECTOR
31510 CTY 23
AKELEY MN 56433

Officer/Director/Trustee Two

JAMES DIETZ
ASST. DIRECTOR
24835 HIGHWOOD TRAIL
AKELEY MN 56433

Officer/Director/Trustee Three

CINDY DIETZ
VOLUNTEER SECRETARY
24835 HIGHWOOD TRAIL
AKELEY MN 56433

Officer/Director/Trustee Four

SHIRLEY TATRO
BOARD MEMBER
28115 230TH ST
AKELEY MN 56433

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/2006
Organization Incorporation State MN
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 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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