FORM 1023-EZ for KAYDE SUE FAULKENBURG MEMORIAL FOUNDATION INC

Field Data
EIN 84-2003404
Case Number EO-2019212-000330
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KAYDE SUE FAULKENBURG MEMORIAL FOUNDATION INC
Organization’s Mailing Address 11006 HIGHWAY 60
City SELLERSBURG
State IN
ZIP 47172
Accounting period End 6
Primary contact name STACEY VICK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DODI VICK
PRESIDENT
11964 E HONEY RUN RD
PEKIN IN 47165

Officer/Director/Trustee Two

CHELSI WRIGHT
TREASURER
2631 S MILL CREEK RD
SALEM IN 47167

Officer/Director/Trustee Three

STACEY VICK
SECRETARY
11006 HIGHWAY 60
SELLERSBURG IN 47172

Organization’s website WWW.KAYDESUEFOUNDATION.COM
Organization’s email 72103@KAYDESUEFOUNDATION.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/5/19
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 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 STACEY VICK
Signature Title SECRETARY
Signature Date 7/29/19

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