FORM 1023-EZ for PORTLAND-UPPER MT BETHEL FOOD PANTRY INC

Field Data
EIN 45-3817436
Case Number EO-2015278-000384
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PORTLAND-UPPER MT BETHEL FOOD PANTRY INC
Organization’s Mailing Address 100 DIVISION ST PO BOX 69
City PORTLAND
State PA
ZIP 18351
Accounting period End 12
Primary contact name RAYMOND DILIONE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MARJORIE BUSH
DIRECTOR
PO BOX 284 103 MAPLE ST
PORTLAND PA 18351

Officer/Director/Trustee Two

ELWOOD SEAS
TREASURER
W30 LINDA DR MOBILE HOME PARK
WALNUTPORT PA 18088

Officer/Director/Trustee Three

LAUREN LEBKUECHER
SECRETARY
PO BOX 185
PORTLAND PA 18351

Officer/Director/Trustee Four

SHERMAN LABARRE
OPERATIONS MANAGER
PO BOX 575
PORTLAND PA 18351

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/11/2014
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K30 - Food Service, Free Food Distribution Programs
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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