FORM 1023-EZ for THE MODIFIED DOLLS MISSOURI CHAPTER

Field Data
EIN 30-0798450
Case Number EO-2015070-000870
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE MODIFIED DOLLS MISSOURI CHAPTER
Organization’s Mailing Address 5803 N PARK
City GLADSTONE
State MO
ZIP 64118
Accounting period End 12
Primary contact name MEGAN BIRZER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MEGAN BIRZER
HEAD DOLL
5803 N PARK
GLADSTONE MO 64118

Officer/Director/Trustee Two

FELICIA PITTMAN
SECOND IN COMMAND
161 KALE COURT
ST. ROBERT MO 65584

Officer/Director/Trustee Three

JOHNNA HUBBARD
BOARD MEMBER
530 NW 80TH TER
KANSAS CITY MO 64118

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/16/2013
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T50 - Philanthropy, Charity, Voluntarism Promotion, General
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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