FORM 1023-EZ for KVAC EYE BELIEVE INC

Field Data
EIN 84-3981094
Case Number EO-2020072-000163
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KVAC EYE BELIEVE INC
Organization’s Mailing Address 116 VINELAND PARKWAY DR
City VINE GROVE
State KY
ZIP 40175-8447
Accounting period End 12
Primary contact name SHERMEL TILLMAN LEWIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHERMEL TILLMAN LEWIS
PRESIDENT
116 VINELANDPARKWAY DR
VINE GROVE KY 40175-8447

Officer/Director/Trustee Two

KIMBERLY BUSH
SECRETARY
252 LAVISTA DR
RINEYVILLE KY 40162-9414

Officer/Director/Trustee Three

FELICIA HARRIS
TREASURER
3004 MARY CREST DR
SHELBYVILLE KY 40065-6354

Officer/Director/Trustee Four

TAMELA SALDANA
BOARD MEMBER
2900 COHOBA DR
AUSTIN TX 78748-5072

Officer/Director/Trustee Five

KIMBERLEY JORDAN
BOARD MEMBER
200 WHITWORTH WAY APT 307
WILLIAMSBURG VA 23185-3719

Organization’s website N/A
Organization’s email KVACEYEBELIEVE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/20/2019
Organization Incorporation State KY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds Yes
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 SHERMEL TILLMAN LEWIS
Signature Title PRESIDENT
Signature Date 3/10/2020

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