FORM 1023-EZ for KIWANIS CLUB OF LIVE OAK INC

Field Data
EIN 13-4353351
Case Number EO-2017124-000133
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KIWANIS CLUB OF LIVE OAK INC
Organization’s Mailing Address PO BOX 568
City LIVE OAK
State FL
ZIP 32064
Accounting period End 9
Primary contact name MONJA SLATER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KELLY RENFROE
PRESIDENT
12946 88TH TER
LIVE OAK FL 32060

Officer/Director/Trustee Two

HARDY TILLMAN
VICE PRESIDENT
11122 114TH TRL
LIVE OAK FL 32060

Officer/Director/Trustee Three

JENNIFER HUTCHINS
SECRETARY
10997 114TH TRAIL
LIVE OAK FL 32060

Officer/Director/Trustee Four

MONJA SLATER
TREASURE
576 SW DANTE TER
LAKE CITY FL 32024

Officer/Director/Trustee Five

DANNY HALES
BOARD MEMBER
13337 CR 136
LIVE OAK FL 32060

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/8/2006
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P30 - Children's, Youth Services
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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