FORM 1023-EZ for ANIMAL FOOD BANK OF WNY INC

Field Data
EIN 81-4447512
Case Number EO-2016330-000137
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ANIMAL FOOD BANK OF WNY INC
Organization’s Mailing Address 154 ORCHARD PARK RD
City WEST SENECA
State NY
ZIP 14224
Accounting period End 12
Primary contact name KEVIN JACOBI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KIM JACOBI
DIRECTOR, PRESIDENT
PO BOX 280
BOSTON NY 14025

Officer/Director/Trustee Two

KEVIN JACOBI
DIRECTOR, V.P., SEC., TREAS.
PO BOX 280
BOSTON NY 14025

Officer/Director/Trustee Three

JOHN RITZENTHALER
DIRECTOR
PO BOX 105
BOSTON NY 14025

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/15/2016
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D12 - Fund Raising and/or Fund Distribution
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 Yes
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
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
Signature Title
Signature Date

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