FORM 1023-EZ for KOZAKS CARES INC

Field Data
EIN 84-2855334
Case Number EO-2019241-000383
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KOZAKS CARES INC
Organization’s Mailing Address 1018 S 169 HIGHWAY
City SMITHVILLE
State MO
ZIP 64089
Accounting period End 12
Primary contact name BRIAN HOVE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRIAN HOVE
PRESIDENT
404 LAKEVIEW DRIVE
SMITHVILLE MO 64089

Officer/Director/Trustee Two

KODY KREMS
VICE PRESIDENT
217 WOODHAVEN
SMITHVILLE MO 64089

Officer/Director/Trustee Three

KAREN LANE
TREASURER
16435 B HIGHWAY
SMITHVILLE MO 64089

Officer/Director/Trustee Four

JACQUIE HOVE
SECRETARY
404 LAKEVIEW DRIVE
SMITHVILLE MO 64089

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/26/19
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T31 - Community Foundations
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 BRIAN HOVE
Signature Title PRESIDENT
Signature Date 8/27/19

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