FORM 1023-EZ for SMITHFIELD LIONS FOUNDATION

Field Data
EIN 86-3236567
Case Number EO-2021181-000341
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SMITHFIELD LIONS FOUNDATION
Organization’s Mailing Address 48 BLUE SPRUCE CIR
City CLAYTON
State NC
ZIP 27527
Accounting period End 6
Primary contact name GRANT TRUESDALE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KAREN BROWN
PRESIDENT
582 LITTLE CREEK CHURCH RD
CLAYTON NC 27520

Officer/Director/Trustee Two

GRANT TRUESDALE
FIRST VICE PRESIDENT
48 BLUE SPRUCE CIR
CLAYTON NC 27527

Officer/Director/Trustee Three

JEANETTE MASSENGILL
SECOND VICE PRESIDENT
1010 S BRIGHTLEAF BLVD
SMITHFIELD NC 27577

Officer/Director/Trustee Four

KATHY GURLEY
SECRETARY
2008 DEER TRAIL
CLAYTON NC 27527

Officer/Director/Trustee Five

JANA PEEDIN
TREASURER
3610 US 701 SOUTH
FOUR OAKS NC 27524

Organization’s website SMITHFIELD LIONS CLUB
Organization’s email GTRUESDALE@EC.RR.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/30/1950
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G41 - Eye Diseases, Blindness and Vision Impairments
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 GRANT TRUESDALE
Signature Title FIRST VICE PRESIDENT
Signature Date 6/28/2021

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