FORM 1023-EZ for 4 SAINTS EPISCOPAL FOOD PANTRY

Field Data
EIN 81-5377994
Case Number EO-2018043-000173
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name 4 SAINTS EPISCOPAL FOOD PANTRY
Organization’s Mailing Address 4301 MEADOWBROOK DR
City FORT WORTH
State TX
ZIP 76103
Accounting period End 12
Primary contact name JANE JOLLEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PATTI CALLAHAN
PRESIDENT
5012 KEMBLE ST
FORT WORTH TX 76103

Officer/Director/Trustee Two

KEVIN JOHNSON
VICE-PRESIDENT
410 W 7TH ST APT 1704
FORT WORTH TX 76102

Officer/Director/Trustee Three

DIANE SNOW
SECRETARY
205 HILLVIEW DR
HURST TX 76054

Officer/Director/Trustee Four

RICHARD KERN
TREASURER
426 LOCH N GREEN TR
ARLINGTON TX 76012

Officer/Director/Trustee Five

MITCH HEROD
DIRECTOR
6228 WINDEMERE PL
FORT WORTH TX 76112

Organization’s website N/A
Organization’s email JANEJOLLEY@JJANDPARTNERS.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/1/16
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K31 - Food Banks, Food Pantries
Organization’s purpose Charitable: Yes
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 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 PATTI CALLAHAN
Signature Title PRESIDENT
Signature Date 2/8/18

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