FORM 1023-EZ for KENS ETERNAL FIRE KIDNEY FOUNDATION

Field Data
EIN 47-3987442
Case Number EO-2015337-000028
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KENS ETERNAL FIRE KIDNEY FOUNDATION
Organization’s Mailing Address 724 OLD FLORAL CITY ROAD
City INVERNESS
State FL
ZIP 34450
Accounting period End 12
Primary contact name R A COHEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

GAYLE STEWART
DIRECTOR
724 OLD FLORAL CITY ROAD
INVERNESS FL 34450

Officer/Director/Trustee Two

KENNETH STEWART
DIRECTOR
724 OLD FLORAL CITY ROAD
INVERNESS FL 34450

Officer/Director/Trustee Three

MAKAYLA STEWART
DIRECTOR
724 OLD FLORAL CITY ROAD
INVERNESS FL 34450

Officer/Director/Trustee Four

KEVIN TROUTNER
DIRECTOR
4448 CLEARWATER HARBOR DR NORTH
LARGO FL 33770

Officer/Director/Trustee Five

CINDY CRIPPEN
DIRECTOR
1129 NE 11TH STREET
CAPE CORAL FL 33909

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/4/2015
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Z99 - Unclassified
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: Yes
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 Yes
Conducting Activities Outside of United States Yes
Financial transactions with officers Yes
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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