FORM 1023-EZ for KANSAS CITY FOUNDATION FOR PULMONARY FIBROSIS

Field Data
EIN 83-1643315
Case Number EO-2018239-000507
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KANSAS CITY FOUNDATION FOR PULMONARY FIBROSIS
Organization’s Mailing Address 13725 METCALF AVE BOX 286
City OVERLAND PARK
State KS
ZIP 66223
Accounting period End 12
Primary contact name MARK HAMBLIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARK HAMBLIN
DIRECTOR, PRESIDENT
14101 NIEMAN RD
OVERLAND PARK KS 66221

Officer/Director/Trustee Two

KRISTY DELANEY
DIRECTOR, VICE PRESIDENT
7726 NOLAND RD
LENEXA KS 66216

Officer/Director/Trustee Three

KIMBERLY LOVELL
DIRECTOR, TREASURER
2206 W 79TH ST
PRAIRIE VILLAGE KS 66208

Officer/Director/Trustee Four

JAMIE LUDWIG
DIRECTOR, SECRETARY
24210 W 123RD TERR
OLATHE KS 66061

Officer/Director/Trustee Five

JANELL REICHUBER
DIRECTOR
12502 S ACUFF CT
OLATHE KS 66062

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/23/18
Organization Incorporation State KS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G45 - Lung Disease
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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 Yes
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 MARK HAMBLIN
Signature Title DIRECTOR, PRESIDENT
Signature Date 8/23/18

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