FORM 1023-EZ for LITTLE ROCK AME ZION FERNLAND COMMUNITY FOUNDATION

Field Data
EIN 82-5186287
Case Number EO-2018109-000658
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LITTLE ROCK AME ZION FERNLAND COMMUNITY FOUNDATION
Organization’s Mailing Address 10010 FERNLAND ROAD
City GRAND BAY
State AL
ZIP 36541
Accounting period End 12
Primary contact name HERMAN THOMAS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NATHANIEL WILDER
PRESIDENT
168 STANTON ROAD
MOBILE AL 36617

Officer/Director/Trustee Two

HERMAN THOMAS
SECRETARY
2200 RUE DE LEFLORE DRIVE
MOBILE AL 36617

Officer/Director/Trustee Three

WALTER STALLWORTH
VICE-PRESIDENT
10550 WALKER ROAD EXT
GRAND BAY AL 36541

Officer/Director/Trustee Four

RUBEN MILLER
ASSIST TREASURE
10551 WASHINGTON ROAD
GRAND BAY AL 36541

Officer/Director/Trustee Five

GAIL COOK
ASSIST SECRETARY
10450 SMITH ROAD
GRAND BAY AL 35541

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/16/18
Organization Incorporation State AL
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: 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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name HERMAN THOMAS
Signature Title SECRETARY
Signature Date 4/17/18

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