FORM 1023-EZ for TEAM KENZEY FOUNDATION INC

Field Data
EIN 82-2166498
Case Number EO-2017233-000087
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TEAM KENZEY FOUNDATION INC
Organization’s Mailing Address 896 PINE RIDGE RD
City MOCKSVILLE
State NC
ZIP 27028
Accounting period End 12
Primary contact name DIANE SMITH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JESSICA PHELPS
PRESIDENT
896 PINE RIDGE RD
MOCKSVILLE NC 27028

Officer/Director/Trustee Two

DIANE SMITH
VICE PRESIDENT
3840 SHUE RD
SALISBURY NC 28147

Officer/Director/Trustee Three

CHARLES PHELPS
BOARD MEMBER
896 PINE RIDGE RD
MOCKSVILLE NC 27028

Officer/Director/Trustee Four

JASON SMITH
BOARD MEMBER
3840 SHUE RD
SALISBURY NC 28147

Organization’s website
Organization’s email TKFOUNDATION2017@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/9/2017
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E60 - Health Support Services
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 Yes
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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