FORM 1023-EZ for KOINONIA FOOD PANTRY INC

Field Data
EIN 36-3904164
Case Number EO-2018249-000262
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KOINONIA FOOD PANTRY INC
Organization’s Mailing Address 310 FIFTH STREET PO BOX 68
City LACON
State IL
ZIP 61540
Accounting period End 12
Primary contact name ELIZABETH A BECK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RUTH KLEPPIN
PRESIDENT
865 STATE ROUTE 26
LACON IL 61540

Officer/Director/Trustee Two

RONALD KLEPPIN
VICE PRESIDENT
518 N OLIVE STREET
TOLUCA IL 61369

Officer/Director/Trustee Three

ELIZABETH MAYER
SECRETARY
606 S PRAIRIE STREET
LACON IL 61540

Officer/Director/Trustee Four

JENNIFER KOEHLER
TREASURER
362 CO RD 650N
SPARLAND IL 61565

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/16/18
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K30 - Food Service, Free Food Distribution Programs
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name RUTH KLEPPIN
Signature Title PRESIDENT
Signature Date 9/4/18

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