FORM 1023-EZ for FORGET-ME-NOT CHILDRENS CENTER INC

Field Data
EIN 61-1387977
Case Number EO-2016125-000220
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FORGET-ME-NOT CHILDRENS CENTER INC
Organization’s Mailing Address 3227 COLEMAN ROAD
City PADUCAH
State KY
ZIP 42001
Accounting period End 6
Primary contact name JEFFREY L WALKER CPA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SHELLY BAER
PRESIDENT
105 CARNOUSTIE COURT
PADUCAH KY 42001

Officer/Director/Trustee Two

AMBER EDWARDS
SECRETARY
1046 CLARKS FERRY RD
LEDBETTER KY 42058

Officer/Director/Trustee Three

KRISTEN ROBERTS
TREASURER
103 BUTLER LANE
CALVERT CITY KY 42029

Officer/Director/Trustee Four

KEVIN BAER
DIRECTOR
105 CARNOUSTIE COURT
PADUCAH KY 42001

Officer/Director/Trustee Five

SARAH MCGEE
DIRECTOR
797 JUNIPER STREET
CALVERT CITY KY 42029

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/23/2001
Organization Incorporation State KY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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