FORM 1023-EZ for KIAMICHI FAMILY FOUNDATION

Field Data
EIN 87-1562032
Case Number EO-2021190-000242
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KIAMICHI FAMILY FOUNDATION
Organization’s Mailing Address 403 S INDIAN RD
City IDABEL
State OK
ZIP 74745-5458
Accounting period End 12
Primary contact name KARA MANESS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

VICTOR CLAY
PRESIDENT
1007 MANCHESTER DR
IDABEL OK 74745-7035

Officer/Director/Trustee Two

JO ANN DEAL JOHNSON
VICE-PRESIDENT
107 BURRIS AVE
IDABEL OK 74745-5500

Officer/Director/Trustee Three

CHANDRA RICKEY
TREASURER
1200 ROCK HILL CEMETERY RD
BROKEN BOW OK 74728-7193

Officer/Director/Trustee Four

RHONDA REED
INCORPORATOR
221 OXBOW LANE
BROKEN BOW OK 74728-7006

Officer/Director/Trustee Five

STEPHANIE CALLAHAM
INCORPORATOR
PO BOX 307
BROKEN BOW OK 74728-0307

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/6/2021
Organization Incorporation State OK
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E12 - 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 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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JO ANN DEAL JOHNSON
Signature Title VICE-PRESIDENT
Signature Date 7/7/2021

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