FORM 1023-EZ for CENTRAL DAKOTA FOOD PANTRY

Field Data
EIN 81-4815986
Case Number EO-2018117-000095
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CENTRAL DAKOTA FOOD PANTRY
Organization’s Mailing Address PO BOX 31
City HARVEY
State ND
ZIP 58341
Accounting period End 12
Primary contact name DAVID LAUTT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID LAUTT
PRESIDENT
2170 29TH AVE NE
HARVEY ND 58341-9329

Officer/Director/Trustee Two

JUDY FRUEH
SECRETARY
2431 21ST AVE NE
MARTIN ND 58758-9225

Officer/Director/Trustee Three

MARSHALL ERICKSON
TREASURER
210 9TH ST E
HARVEY ND 58341-1620

Officer/Director/Trustee Four

KATHY GROSSMAN
OFFICER
421 BIRCH AVE
HARVEY ND 58341-1122

Officer/Director/Trustee Five

DANELLE OLSON
OFFICER
605 1ST ST E
ANAMOOSE ND 58710-4109

Organization’s website
Organization’s email CDMAFOODPANTRY@GONDTC.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/1/17
Organization Incorporation State ND
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K30 - Food Service, Free Food Distribution Programs
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 MARSHALL ERICKSON
Signature Title TREASURER
Signature Date 4/25/18

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