FORM 1023-EZ for ROBERT AND CLARA PENCHION FOUNDATION

Field Data
EIN 82-2854606
Case Number EO-2018072-000183
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ROBERT AND CLARA PENCHION FOUNDATION
Organization’s Mailing Address 3480 KIRBY RD
City MEMPHIS
State TN
ZIP 38115
Accounting period End 12
Primary contact name NYRONE HAWKINS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NYRONE HAWKINS
INCORPORATOR
8690 MEADOWVALE DR
MEMPHIS TN 38125

Officer/Director/Trustee Two

ROBERT PENCHION
INCORPORATOR
3480 KIRBY RD
MEMPHIS TN 38125

Officer/Director/Trustee Three

CLARA PENCHION
INCORPORATOR
3480 KIRBY RD
MEMPHIS CA 38125

Officer/Director/Trustee Four

CARLTON PEOPLES
ACCOUNTANT
1021
MEMPHIS TN 38106

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/21/17
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T04 -
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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 Yes
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 CARLTON PEOPLES
Signature Title ACCOUNTANT
Signature Date 3/9/18

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