FORM 1023-EZ for CANCERVIVE KC

Field Data
EIN 90-1013284
Case Number EO-2015020-000065
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CANCERVIVE KC
Organization’s Mailing Address 2804 N WALROND AVE
City KANSAS CITY
State MO
ZIP 64117
Accounting period End 12
Primary contact name KATIE BIEBERLY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LINDSEY JOSEPHINE
PRESIDENT
1233 NE 43RD TERRACE
KANSAS CITY MO 64116

Officer/Director/Trustee Two

MISTI MATHIS-KING
TREASURER
2804 N WALROND AVE
KANSAS CITY MO 64117

Officer/Director/Trustee Three

AARON PARK
DIRECTOR
10439 N FORREST AVE
KANSAS CITY MO 64155

Officer/Director/Trustee Four

KATIE BIEBERLY
SECRETARY
4459 N CHESTNUT AVE
KANSAS CITY MO 64117

Officer/Director/Trustee Five

PATRICK KING
DIRECTOR
2804 N WALROND AVE
KANSAS CITY MO 64117

Organization’s website CANCERVIVEKC.COM
Organization’s email CANCERVIVEKC@HOTMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/17/2014
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P12 - Fund Raising and/or Fund Distribution
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 Yes
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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