FORM 1023-EZ for KELLYS CAMP FOUDATION

Field Data
EIN 47-1092269
Case Number EO-2015358-000139
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KELLYS CAMP FOUDATION
Organization’s Mailing Address 3 ANACONDA HILLS DRIVE
City BLACK EAGLE
State MT
ZIP 59414
Accounting period End 12
Primary contact name PHILIP M FACCENDA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ROBERT KELLENBECK
PRESIDENT
PO BOX 91
ABIQUIU NM 87510

Officer/Director/Trustee Two

PHILIP FACCENDA
VICE PRESIDENT
2926 4TH AVENUE NORTH
GREAT FALLS MT 59401

Officer/Director/Trustee Three

PHYLLIS COX
SECRETARY
14 BEECHWOOD PLACE
WATCHUNG NJ 07069

Organization’s website N/A
Organization’s email PHIL@STRAYMOOSE.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/20/2014
Organization Incorporation State MT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A80 - Historical Societies, Related Historical Activities
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 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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