FORM 1023-EZ for MADRAS COMMUNITY FOOD PANTRY

Field Data
EIN 83-1106063
Case Number EO-2021093-000336
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MADRAS COMMUNITY FOOD PANTRY
Organization’s Mailing Address 49 NE 12TH STREET
City MADRAS
State OR
ZIP 97741
Accounting period End 12
Primary contact name JERED REID
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KATHLEEN MAY
PRESIDENT
408 NE HILLCREST STREET
MADRAS OR 97741

Officer/Director/Trustee Two

PATTY LIEUALLEN
DIRECTOR/CHAIR
364 WOODSIDE COURT
MADRAS OR 97741

Officer/Director/Trustee Three

PAT HASTINGS
VICE PRESIDENT/DIRECTOR
120 NW LEE STREET
MADRAS OR 97741

Officer/Director/Trustee Four

SHARON MARVEL
SECRETARY/DIRECTOR
722 SE ALLEN DRIVE
MADRAS OR 97741

Officer/Director/Trustee Five

DONNA HAGEDORN
TREASURER/DIRECTOR
30 SW CRESTVIEW
MADRAS OR 97741

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/19/2021
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K31 - Food Banks, Food Pantries
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 KATHLEEN MAY
Signature Title PRESIDENT
Signature Date 2/28/2021

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