FORM 1023-EZ for TABLE ONE MINISTRIES

Field Data
EIN 47-2294205
Case Number EO-2014349-000312
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TABLE ONE MINISTRIES
Organization’s Mailing Address 1 N DETROIT STREET
City KENTON
State OH
ZIP 43326
Accounting period End 12
Primary contact name LORAN MIRACLE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LORAN MIRACLE
PRESIDENT
667 N WAYNE ST
KENTON OH 43326

Officer/Director/Trustee Two

BERNARD FURBUSH
TREASURER
21662 CO RD 190
MT VICTORY OH 43340

Officer/Director/Trustee Three

MARTHA FURBUSH
SECRETARY
21662 CO RD 190
MT VICTORY OH 43340

Officer/Director/Trustee Four

JEFF WAITE
MEMBER
7063 US HIGHWAY 68
KENTON OH 43326

Officer/Director/Trustee Five

PHIL COMPTON
MEMBER
0475 TR 30
ADA OH 45810

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/11/2014
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K35 - Eatery, Agency, Organization Sponsored
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 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
Signature Title
Signature Date

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