FORM 1023-EZ for AMERICAN GRATITUDE INC

Field Data
EIN 81-1263733
Case Number EO-2017038-000248
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name AMERICAN GRATITUDE INC
Organization’s Mailing Address 01806 E US HIGHWAY 50
City PIERCEVILLE
State KS
ZIP 67868-9348
Accounting period End 12
Primary contact name BRIAN BEAVERS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRIAN BEAVERS
CO-CHAIRMAN
01806E US HWY 50
PIERCEVILLE KS 67868-9348

Officer/Director/Trustee Two

BYRON PEIRANO
CO-CHAIRMAN
2611 N 7TH ST
GARDEN CITY KS 67846-3053

Officer/Director/Trustee Three

LINDA PEIRANO
SECRETARY/TREASURER
2611 N 7TH ST
GARDEN CITY KS 67846-3053

Officer/Director/Trustee Four

SHANNON SELSTEDT
DIRECTOR
164 S MAPLE DUNES ST
WICHITA KS 67235-7505

Officer/Director/Trustee Five

LEE JANTZ
DIRECTOR
109 E SANTA FE
CIMARRON KS 67835-0109

Organization’s website WWW.AMERICANGRATITUDE.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/29/2016
Organization Incorporation State KS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W30 - Military, Veterans' Organizations
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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