FORM 1023-EZ for MISSIO DEI COMMUNITY

Field Data
EIN 27-2066297
Case Number EO-2014268-000437
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MISSIO DEI COMMUNITY
Organization’s Mailing Address 510 NORTH 200 WEST
City SALT LAKE CITY
State UT
ZIP 84116
Accounting period End 12
Primary contact name DAVID R YORK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KYLE COSTELLO
DIRECTOR
510 NORTH 200 WEST
SALT LAKE CITY UT 84116

Officer/Director/Trustee Two

BRENT STORMS
DIRECTOR
938 BROADWAY STE 404
NEW YORK NY 10010

Officer/Director/Trustee Three

BARRY CAMERON
DIRECTOR
938 BROADWAY STE 404
NEW YORK NY 10010

Officer/Director/Trustee Four

LUKE HENDRIX
DIRECTOR
938 BROADWAY STE 404
NEW YORK NY 10010

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/15/2010
Organization Incorporation State UT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
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 Yes
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
Signature Title
Signature Date

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