FORM 1023-EZ for BLAIRSVILLE KIWANIS FOUNDATION INCE

Field Data
EIN 82-1691484
Case Number EO-2017153-000288
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BLAIRSVILLE KIWANIS FOUNDATION INCE
Organization’s Mailing Address PO BOX 1732
City BLAIRSVILLE
State GA
ZIP 30514
Accounting period End 12
Primary contact name JOHN CONE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KATHLEEN MCMILLAN
DIRECTOR
79 BIRCH CANE DR
BLAIRSVILLE GA 30512

Officer/Director/Trustee Two

THOMAS SHORES
DIRECTOR
73 WILDWIND LANE
BLAIRSVILLE GA 30512

Officer/Director/Trustee Three

JOHN CONE
DIRECTOR
PO BOX 2478
BLAIRSVILLE GA 30514

Officer/Director/Trustee Four

SIDNEY MAHAN
DIRECTOR
PO BOX 1564
BLAIRSVILLE GA 30514

Officer/Director/Trustee Five

JUDY LANIER
DIRECTOR
885 TOMAHAWK TRAIL
BLAIRSVILLE GA 30512

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/2/2017
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Y12 - 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 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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