FORM 1023-EZ for KIWANIS CLUB OF WEST SHORE FOUNDATION

Field Data
EIN 23-2552327
Case Number EO-2016278-000341
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KIWANIS CLUB OF WEST SHORE FOUNDATION
Organization’s Mailing Address P O BOX 84
City LEMOYNE
State PA
ZIP 17043
Accounting period End 9
Primary contact name SHIRLEY ROUZER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHRISTINE LEUKUS
PRESIDENT
415 JENNIFER DRIV
NEW CUMBERLAND PA 17070

Officer/Director/Trustee Two

SHIRLEY ROUZER
TREASURER
8 GRINNEL DRIVE
CAMP HILL PA 17011

Officer/Director/Trustee Three

ROBERT DUNN
DIRECTOR
3909 BROOKRIDGE DRIVE
MECHANICSBURG PA 17050

Officer/Director/Trustee Four

CALVIN WILLIAMS
DIRCTOR
233 ALLENDALE WAY
CAMP HILL PA 17011

Officer/Director/Trustee Five

DONALD MCCALLIN
DIRECTOR
501 LAMP POST LANE
CAMP HILL PA 17011

Organization’s website NONE
Organization’s email SROUZER40@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/8/1988
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P12 - Fund Raising and/or Fund Distribution
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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