FORM 1023-EZ for COMMUNITY HYGIENE PANTRY

Field Data
EIN 85-3034986
Case Number EO-2020265-000336
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name COMMUNITY HYGIENE PANTRY
Organization’s Mailing Address 311 S BLAYNEY ST
City ALEXIS
State IL
ZIP 61412
Accounting period End 12
Primary contact name DEANNA TROUT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DEANNA TROUT
EXECUTIVE DIRECTOR/PRESIDENT
311 S BLAYNEY ST
ALEXIS IL 61412

Officer/Director/Trustee Two

TONYA KUPER
VICE PRESIDENT
17522 KAREN ST
OMAHA NE 68135

Officer/Director/Trustee Three

CINDY HARSHBARGER
VICE PRESIDENT
336 SHELTON ST
CAMERON IL 61423

Officer/Director/Trustee Four

ERIN VAN HOUWE
SECRETARY
512 CARE ST
CAMERON IL 61423

Officer/Director/Trustee Five

JENNY SPAHNE
TREASURER
120 HASTINGS WAY
MONMOUTH IL 61462

Organization’s website COMMUNITYHYGIENEPANTRY.ORG
Organization’s email DTROUT@COMMUNITYHYGIENEPANTRY.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/8/2020
Organization Incorporation State IL
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 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 DEANNA TROUT
Signature Title EXECUTIVE DIRECTOR/PRESIDENT
Signature Date 9/17/2020

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