FORM 1023-EZ for RAYBURN FAMILY FOUNDATION

Field Data
EIN 84-3990611
Case Number EO-2020015-000170
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name RAYBURN FAMILY FOUNDATION
Organization’s Mailing Address 3720 ESTERO BLVD
City FT MYERS BEACH
State IA
ZIP 33931
Accounting period End 12
Primary contact name DIANE E PUTHOFF
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHRISTOPHER A RAYBURN
PRESIDENT/TREASURER/DIRECTOR
3720 ESTERO BLVD
FT MYERS BEACH FL 33931

Officer/Director/Trustee Two

MARY S RAYBURN
VICE PRES/SECRETARY/DIRECTOR
3720 ESTERO BLVD
FT MYERS BEACH FL 33931

Officer/Director/Trustee Three

NINA L RAYBURN
DIRECTOR
5510 LONGVIEW STREET
DALLAS TX 75206

Officer/Director/Trustee Four

CLAIRE E RAYBURN
DIRECTOR
2049 NORTH CLIFTON THIRD FLOOR
CHICAGO IL 60614

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/16/2019
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S99 - Community Improvement, Capacity Building N.E.C.
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: Yes
Literary: Yes
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 No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name CHRISTOPHER A RAYBURN
Signature Title PRESIDENT/TREASURER/DIRECTOR
Signature Date 1/13/2020

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