FORM 1023-EZ for WELLS CLAYTON WHITWORTH MEMORIAL FOUNDATION

Field Data
EIN 84-3797314
Case Number EO-2019333-000151
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name WELLS CLAYTON WHITWORTH MEMORIAL FOUNDATION
Organization’s Mailing Address 124 KINGLET WAY
City MADISON
State AL
ZIP 35756
Accounting period End 12
Primary contact name STEVEN B SWINDALL CPA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KELLEY WHITWORTH
PRESIDENT
124 KINGLET WAY
MADISON AL 35756

Officer/Director/Trustee Two

CHAD WHITWORTH
VICE-PRESIDENT
124 KINGLET WAY
MADISON AL 35756

Officer/Director/Trustee Three

T J THOMAS
SECRETARY/TREASURER
394 YANCY RD
MADISON AL 35756

Organization’s website
Organization’s email KLM5664@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/2/19
Organization Incorporation State AL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P46 - Family Counseling
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 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 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 KELLEY WHITWORTH
Signature Title PRESIDENT
Signature Date 11/26/19

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