FORM 1023-EZ for HIGHLAND FOOTBALL MOMS CLUB

Field Data
EIN 47-3401364
Case Number EO-2016014-000412
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HIGHLAND FOOTBALL MOMS CLUB
Organization’s Mailing Address 27915 STATE HWY N
City EWING
State MO
ZIP 63440
Accounting period End 12
Primary contact name MELISSA KLOCKE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MELISSA KLOCKE
PRESIDENT
27915 STATE HWY N
EWING MO 63440

Organization’s website
Organization’s email MELISSAKLOCKE80@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/13/2015
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A12 - Fund Raising and/or Fund Distribution
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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