FORM 1023-EZ for THE JOHN LUMPKIN MEMORIAL FUND INC

Field Data
EIN 47-1337712
Case Number EO-2015196-000133
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE JOHN LUMPKIN MEMORIAL FUND INC
Organization’s Mailing Address 39 FARMINGTON AVE D4
City PLAINVILLE
State CT
ZIP 06062
Accounting period End 4
Primary contact name MARK ANDELIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KELLY LUMPKIN
PRESIDENT
39 FARMINGTON AVE D4
PLAINVILLE CT 06062

Officer/Director/Trustee Two

MARK ANDELIN
VICE PRESIDENT
718 MOUNT VERNON RD
SOUTHINGTON CT 06489

Officer/Director/Trustee Three

JOSEPH OPAROWSKI
TREASURER
351 KNOB HILL RD
MERIDEN CT 06451

Officer/Director/Trustee Four

LAUREN AKINS
DIRECTOR
50 METACOMET RD
PLAINVILLE CT 06062

Officer/Director/Trustee Five

LEE AKINS
DIRECTOR
50 METACOMET RD
PLAINVILLE CT 06062

Organization’s website
Organization’s email MARKANDELIN@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/1/2015
Organization Incorporation State CT
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: 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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