FORM 1023-EZ for JACQUELINE KIRBY NKH FUNDING PROJECT

Field Data
EIN 84-4789056
Case Number EO-2020209-000787
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name JACQUELINE KIRBY NKH FUNDING PROJECT
Organization’s Mailing Address 16638 E SUMMIT AVE
City ELKTON
State VA
ZIP 22827
Accounting period End 12
Primary contact name E
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

EDWARD KIRBY
PRESIDENT
16638 E SUMMIT AVE
ELKTON VA 22827

Officer/Director/Trustee Two

KRISTIAN KIRBY
VICE PRESIDENT
16638 E SUMMIT AVE
ELKTON VA 22827

Officer/Director/Trustee Three

VIRGINIA POLING
SECRETARY
819 MASON ST
DAYTON VA 22821

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/18/2020
Organization Incorporation State VA
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 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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name EDWARD KIRBY
Signature Title PRESIDENT
Signature Date 7/21/2020

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