FORM 1023-EZ for ANDYS KIDS

Field Data
EIN 85-3636780
Case Number EO-2021082-000977
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ANDYS KIDS
Organization’s Mailing Address 5111 UTICA RIDGE RD
City DAVENPORT
State IA
ZIP 52807
Accounting period End 12
Primary contact name STEPHEN CAMPBELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANDREW SALLEE
PRESIDENT
6531 EAGLE RIDGE RD
BETTENDORF IA 52722

Officer/Director/Trustee Two

GARY SIMATOVICH
VICE PRESIDENT
1903 KINGS DR
BETTENDORF IA 52722

Officer/Director/Trustee Three

STEPHEN CAMPBELL
TREASURER
920 CYPRESS
COLONA IL 61241

Organization’s website
Organization’s email SCAMBO@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/27/2020
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K30 - Food Service, Free Food Distribution Programs
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 ANDREW SALLEE
Signature Title PRESIDENT
Signature Date 2/1/2021

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