FORM 1023-EZ for BIRTHDAY SMILES FOR CHILDREN INC

Field Data
EIN 81-3818578
Case Number EO-2016263-000390
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BIRTHDAY SMILES FOR CHILDREN INC
Organization’s Mailing Address 207 PETERSON DRIVE
City ELIZABETHTOWN
State KY
ZIP 42701
Accounting period End 12
Primary contact name CAMERON DAVIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CAMERON DAVIS
PRESIDENT
651 W BRYAN ROAD
ELIZABETHTOWN KY 42701

Officer/Director/Trustee Two

NICOLE MELLOAN
VICE PRESIDENT
705 LANDSDOWNE COURT
ELIZABETHTOWN KY 42701

Officer/Director/Trustee Three

KELLY CLEMENS
TREASURER SECETARY
5 PURDUE COURT
ELIZABETHTOWN KY 42701

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/2/2016
Organization Incorporation State KY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Z99 - Unclassified
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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