FORM 1023-EZ for MYASTHENIA GRAVIS MINNESOTA

Field Data
EIN 81-0802204
Case Number EO-2015349-000284
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MYASTHENIA GRAVIS MINNESOTA
Organization’s Mailing Address 1309 PRIOR AVE S
City ST PAUL
State MN
ZIP 55116
Accounting period End 12
Primary contact name JERRY SMITH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JERRY SMITH
TREASURER
1309 PRIOR AVE S
ST PAUL MN 55116

Officer/Director/Trustee Two

DIANE TOWER
SECRETARY
10525 UTAH RD
BLOOMINGTON MN 55438

Officer/Director/Trustee Three

BARB CORNER
CHAIR
29234 PINEY WAY
BREEZY POINT MN 56472

Officer/Director/Trustee Four

SHIRLEY KRAMER
BOARD MEMBER
14717 SUMMIT OAKS DR
BURNSVILLE MN 55337

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/11/2015
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G96 - Neurology, Neuroscience
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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
Signature Title
Signature Date

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