FORM 1023-EZ for HFMC FOOD PANTRY LLC

Field Data
EIN 82-1045200
Case Number EO-2018337-000068
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HFMC FOOD PANTRY LLC
Organization’s Mailing Address 19111 ELIZABETH BLVD
City MADILL
State OK
ZIP 73446
Accounting period End 12
Primary contact name GWEN WILSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GWEN WILSON
EXECUTIVE DIRECTOR
19123 ELIZABETH BLVD
MADILL OK 73446

Officer/Director/Trustee Two

PATTI SPARLIN
VICE PRESIDENT
PO BOX 576
MADILL OK 73446

Officer/Director/Trustee Three

CARRI RUSSELL
RESOURCE COORDINATOR
301 NORTH 6TH AVENUE
MADILL OK 73446

Officer/Director/Trustee Four

HANNAH WHITMIRE
SECRETARY
17618 PURSER ROAD
MADILL OK 73446

Officer/Director/Trustee Five

KARRI GOSS
TREASURER
PO BOX 301
MADILL OK 73446

Organization’s website
Organization’s email HFMCPANTRY@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/23/17
Organization Incorporation State OK
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K31 - Food Banks, Food Pantries
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 Yes
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 GWEN WILSON
Signature Title EXECUTIVE DIRECTOR
Signature Date 11/29/18

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