FORM 1023-EZ for THE ANN MARIE KEMP FOUNDATION

Field Data
EIN 47-3910964
Case Number EO-2015148-000338
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE ANN MARIE KEMP FOUNDATION
Organization’s Mailing Address 3150 LIVERNOIS SUITE 300
City TROY
State MI
ZIP 48083
Accounting period End 12
Primary contact name THOMAS J OCONNOR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

BUTCH ALFORD
DIRECTOR
4050 FAIRWAY DRIVE
LEWISTON ID 83501

Officer/Director/Trustee Two

RICHARD WYATT
DIRECTOR
2501 17TH STREET
LEWISTON ID 83501

Officer/Director/Trustee Three

SUSAN BERRY
DIRECTOR
5050 BEACH DRIVE SW
SEATTLE WA 98136

Officer/Director/Trustee Four

JOHN B KEMP
DIRECTOR AND PRESIDENT
871 ROYAL BIRKDALE DRIVE
TARPON SPRINGS FL 34688

Officer/Director/Trustee Five

SANDY BIRKO
SECRETARY TREASURER
3150 LIVERNOIS SUITE 300
TROY MI 48083

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/8/2015
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W99 - Public, Society Benefit - 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: Yes
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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