FORM 1023-EZ for KPCI MISSION INC

Field Data
EIN 84-2683834
Case Number EO-2019291-000221
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KPCI MISSION INC
Organization’s Mailing Address 9783 E 116 ST 23491
City FISHERS
State IN
ZIP 46037-2822
Accounting period End 6
Primary contact name SAMUEL E TONEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

HICHUL CHE
TRUSTEE
3724 BADGER DR
CARMEL IN 46033

Officer/Director/Trustee Two

SAMUEL TONEY
PRESIDENT
9783 E 116 ST 23491
FISHERS IN 46037-2822

Officer/Director/Trustee Three

GRACE TONEY
SEC / TREAS
9783 E 116 ST 23491
FISHERS IN 46037-2822

Officer/Director/Trustee Four

KIHEON CHO
TRUSTEE
12198 ARMS RUN
CARMEL IN 46032

Officer/Director/Trustee Five

HEUNG M OON
TRUSTEE
6366 ROBINCOCK DR
CARMEL IN 46268

Organization’s website
Organization’s email SAMTONEYMD@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/17/19
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X21 - Protestant
Organization’s purpose Charitable: Yes
Religious: Yes
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 Yes
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 SAMUEL TONEY
Signature Title PRESIDENT
Signature Date 10/16/19

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