FORM 1023-EZ for CASEY COUNTY 4H COUNCIL INC

Field Data
EIN 26-1419731
Case Number EO-2014310-000061
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CASEY COUNTY 4H COUNCIL INC
Organization’s Mailing Address 1517 S WALLACE WILKINSON BLVD
City LIBERTY
State KY
ZIP 42539
Accounting period End 12
Primary contact name MEAGAN KLEE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

BLAINE STAAT
PRESIDENT
PO BOX 177
LIBERTY KY 42539

Officer/Director/Trustee Two

MEAGAN KLEE
SECRETARY
1416 KY 206
DUNNVILLE KY 42528

Officer/Director/Trustee Three

RHONDA COMBS
TREASURER
2887 KY 206
DUNNVILLE KY 42528

Officer/Director/Trustee Four

JENNIFER GODBEY
DIRECTOR
1922 N KY 127
LIBERTY KY 42539

Officer/Director/Trustee Five

SHELLY WESLEY
DIRECTOR
2506 ROUSE BRANCH RD
LIBERTY KY 42539

Organization’s website HTTPS://CASEY.CA.UKY.EDU/4HYOUTHDEVELOPMENT
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/13/2013
Organization Incorporation State KY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: No
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 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 No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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