FORM 1023-EZ for CANNELTON FOOD PANTRY

Field Data
EIN 86-1934517
Case Number EO-2021089-000108
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CANNELTON FOOD PANTRY
Organization’s Mailing Address 200 N 5TH ST
City CANNELTON
State IN
ZIP 47520
Accounting period End 12
Primary contact name PATRICIA JONES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PATRICIA JONES
DIRECTOR
3976 E STATE RD 66
CANNELTON IN 47520

Officer/Director/Trustee Two

EVELYN ADAMS
PRESIDENT OF BOARD
3222 STATE RD 166
TOBINSPORT IN 47520

Officer/Director/Trustee Three

VICKIE PERFLATISH
SECRETARY
205 11TH ST
TELL CITY IN 47586

Officer/Director/Trustee Four

PAMELA HESS
TREASURER
828 GREEN MEADOWS
CANNELTON IN 47520

Organization’s website
Organization’s email CANNELTONFOODPANTRY@YAHOO.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/2005
Organization Incorporation State IN
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 Yes
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 PATRICIA JONES
Signature Title DIRECTOR
Signature Date 2/9/2021

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