FORM 1023-EZ for TREMPEALEAU COUNTY FOOD PANTRY

Field Data
EIN 83-1158323
Case Number EO-2018197-000306
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TREMPEALEAU COUNTY FOOD PANTRY
Organization’s Mailing Address W20410 STATE RD 121
City WHITEHALL
State WI
ZIP 54773
Accounting period End 12
Primary contact name DAVID MCRAE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID MCRAE
PRESIDENT/ TREASURER
N37383 US HWY 53/121
WHITEHALL WI 54773

Officer/Director/Trustee Two

MICHAEL DEMULLING
VICE PRESIDENT
36340 ELM ST
WHITEHALL WI 54773

Officer/Director/Trustee Three

MEL LEE
SECRETARY
35924 CLAIRE ST
WHITEHALL WI 54773

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/1/17
Organization Incorporation State WI
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: 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 DAVID MCRAE
Signature Title PRESIDENT/ TREASURER
Signature Date 7/12/18

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