FORM 1023-EZ for MINOT INSULIN SERVICES INC

Field Data
EIN 86-3715522
Case Number EO-2021140-000396
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MINOT INSULIN SERVICES INC
Organization’s Mailing Address 117 5TH AVE SW BOX 264
City MINOT
State ND
ZIP 58702
Accounting period End 12
Primary contact name FRANKIE SHAUNA NICOLE MCDOWELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

FRANKIE MCDOWELL
DIRECTOR
1015 27TH ST SE LOT 60 5
MINOT ND 58701

Officer/Director/Trustee Two

GREGORY ROUSEY
DIRECTOR
916 4TH AVE NW
MINOT ND 58703

Officer/Director/Trustee Three

JENNIFER NAPORA
DIRECTOR
401 4TH AVE SW
SURREY ND 58785

Organization’s website
Organization’s email INFO@INSULINSERVICES.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/6/2021
Organization Incorporation State ND
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 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 FRANKIE MCDOWELL
Signature Title DIRECTOR
Signature Date 5/13/2021

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