FORM 1023-EZ for DISTRICT 49B LIONS FOUNDATION INC

Field Data
EIN 91-1145474
Case Number EO-2016006-000256
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DISTRICT 49B LIONS FOUNDATION INC
Organization’s Mailing Address PO BOX 70848
City FAIRBANKS
State AK
ZIP 99707
Accounting period End 6
Primary contact name CHERYL BRADLEY CPA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JOHN BENEVENTO
PRESIDENT
1374 FARMERS LOOP ROAD
FAIRBANKS AK 99709

Officer/Director/Trustee Two

GEORGE PURSEY
VICE PRESIDENT
2282 SPENGLER ROAD
DELTA JUNCTION AK 99737

Officer/Director/Trustee Three

MEGAN RODERIGUES
SECRETARY
1208 BAINBRIDGE ROAD
FAIRBANKS AK 99701

Officer/Director/Trustee Four

MECHELLE NASH
TREASURER
2113 MCCULLAM AVENUE
FAIRBANKS AK 99701

Officer/Director/Trustee Five

ROBERT MARCINKOWSKI
DIRECTOR
176 SUNNY HILLS DRIVE
FAIRBANKS AK 99712

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/1/1981
Organization Incorporation State AK
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T50 - Philanthropy, Charity, Voluntarism Promotion, General
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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