FORM 1023-EZ for JACK FORK USA 1
| Field | Data |
|---|---|
| EIN | 82-3807478 |
| Case Number | EO-2018016-000621 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | JACK FORK USA 1 |
| Organization’s Mailing Address | 444 NORTHWOOD ACRES |
| City | HARTSHORNE |
| State | OK |
| ZIP | 74547 |
| Accounting period End | 12 |
| Primary contact name | JUDY RUSHING |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
LADONNA SOURS
DIRECTOR
91 RILEY AVE
HAILEYVILLE OK 74547
Officer/Director/Trustee Two
JUDY RUSHING
OFFICER
91 RILEY AVE
HAILEYVILLE OK 74547
Officer/Director/Trustee Three
JIMMY RUSHING
OFFICER
444 NORTHWOOD ACRES
HARTSHORNE OK 74547
Officer/Director/Trustee Four
HOPE TWEED
TRUSTEE
91 RILEY AVE
HAILEYVILLE OK 74547
Officer/Director/Trustee Five
LAKEN TWEED
TRUSTEE
91 RILEY AVE
HAILEYVILLE OK 74547
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | No |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 1/1/18 |
| Organization Incorporation State | OK |
| 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 | No |
| One Third Support Gifts | No |
| Benefit of College | No |
| Private Foundation 508(e) | Yes |
| Seeking Retroactive Reinstatement | No |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | LADONNA SOURS |
| Signature Title | DIRECTOR |
| Signature Date | 1/14/18 |
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