FORM 1023-EZ for MOVE FOR MEDICINE

Field Data
EIN 81-4422760
Case Number EO-2017026-000276
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MOVE FOR MEDICINE
Organization’s Mailing Address PO BOX 152182
City ARLINGTON
State TX
ZIP 76015
Accounting period End 12
Primary contact name CATHERINE BASS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LOUIS CORPREW
PRESIDENT/DIRECTOR
4805 MELITA AVE
FORT WORTH TX 76133

Officer/Director/Trustee Two

DENA KIRK
SECRETARY/DIRECTOR
4805 MELITA AVE
FORT WORTH TX 76133

Officer/Director/Trustee Three

CATHERINE BASS
TREASURER/DIRECTOR
PO BOX 152182
ARLINGTON TX 76015

Officer/Director/Trustee Four

TRACI JOHNSON
DIRECTOR
219 SLEEPY HOLLOW LN
COPPELL TX 75019

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/18/2016
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E20 - Hospitals and Related Primary Medical Care Facilities
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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