FORM 1023-EZ for THE MOM OF AN ADDICT INC
| Field | Data |
|---|---|
| EIN | 83-4362757 |
| Case Number | EO-2019130-000019 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | THE MOM OF AN ADDICT INC |
| Organization’s Mailing Address | 10214 CHESTNUT PLAZA DRIVE NUM 142 |
| City | FORT WAYNE |
| State | IN |
| ZIP | 46814 |
| Accounting period End | 12 |
| Primary contact name | JENNIFER HOPE |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
JENNIFER HOPE
CEO
2521 MILL POND CT
FORT WAYNE IN 46804
Officer/Director/Trustee Two
BRADLEY MILLS
BOARD PRESIDENT
15115 CHOPINE PASS
ROANOKE IN 46783
Officer/Director/Trustee Three
ART CHOKENEA
BOARD VICE PRESIDENT
13520 NARROWS COVE
FORT WAYNE IN 46814
Officer/Director/Trustee Four
JENNIFER STREETER
BOARD SECRETARY
1348 LEXINGTON DRIVE
WINONA LAKE IN 46590
Officer/Director/Trustee Five
JULIA KERR
BOARD TREASURER
11127 BARCLAY COVE
ROANOKE IN 46783
| Organization’s website | WWW.THEMOMOFANADDICT.COM |
|---|---|
| Organization’s email | JEN@THEMOMOFANADDICT.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 3/28/19 |
| Organization Incorporation State | IN |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | F60 - Counseling, Support Groups |
| Organization’s purpose | Charitable: Yes Religious: No Educational: Yes 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 | JENNIFER HOPE |
| Signature Title | CEO |
| Signature Date | 5/8/19 |
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