FORM 1023-EZ for ROUNDUP BACKPACK PROGRAM

Field Data
EIN 38-3982175
Case Number EO-2015342-000347
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ROUNDUP BACKPACK PROGRAM
Organization’s Mailing Address PO BOX 384
City ROUNDUP
State MT
ZIP 59072
Accounting period End 12
Primary contact name ROBIN SIBLEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DOREEN RECH
PRESIDENT
324 3RD AVE W
ROUNDUP MT 59072

Officer/Director/Trustee Two

CHERI TATE
VICE PRESIDENT
69 QUAIL DRIVE
ROUNDUP MT 59072

Officer/Director/Trustee Three

ROBIN SIBLEY
TREASURER
915 3RD ST E
ROUNDUP MT 59072

Officer/Director/Trustee Four

NANCY ANDERSON
SECRETARY
407 2ND ST W
ROUNDUP MT 59072

Officer/Director/Trustee Five

PEGGY TOOMBS
MEMBER
101 11TH AVE W
ROUNDUP MT 59072

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/9/2015
Organization Incorporation State MT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K30 - Food Service, Free Food Distribution Programs
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
Signature Title
Signature Date

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