FORM 1023-EZ for MUTATION-STATION INC

Field Data
EIN 83-3010617
Case Number EO-2019038-000631
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MUTATION-STATION INC
Organization’s Mailing Address 26A COUNTRY ROAD 1103
City EMBUDO
State NM
ZIP 87531-395
Accounting period End 12
Primary contact name MEDA BITTERMANN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MEDA BITTERMANN
PRESIDENT & CEO
26A COUNTRY ROAD 1103
EMBUDO NM 87531-395

Officer/Director/Trustee Two

SAM MAJEWSKI
CHAIRPERSON, CFO & REGISTERED AGENT
817 SILVER AVE SW
ALBUQUERQUE NM 87102

Officer/Director/Trustee Three

ELIZABETH ANN MORRIS MILLER
DIRECTOR, OFFICER
2 DESERT SUN CIRCLE
SANTA FE NM 87507

Organization’s website WWW.MUTATION-STATION.COM
Organization’s email MEDABITTER@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/2/19
Organization Incorporation State NM
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A99 - Arts, Culture, and Humanities N.E.C.
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 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 MEDA BITTERMANN
Signature Title PRESIDENT & CEO
Signature Date 2/1/19

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