FORM 1023-EZ for MIND BODY SOUL SURVIVOR

Field Data
EIN 46-3129095
Case Number EO-2020296-000367
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MIND BODY SOUL SURVIVOR
Organization’s Mailing Address 1175 BECHTEL AVE
City MANSFIELD
State OH
ZIP 44905
Accounting period End 3
Primary contact name MICHELLE BOND
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHELLE BOND
DIRECTOR
1175 BECHTEL AVE
MANSFIELD OH 44905

Officer/Director/Trustee Two

LINDSEY MYERS
PRESIDENT
2052 MARTIN ST POINT RD
KITTY HAWK NC 27949

Officer/Director/Trustee Three

MICHAEL MOSLEY
VICE PRESEDENT
1026 SUTHERLAND RD
AKRON OH 44314

Officer/Director/Trustee Four

RICHARD MAROON
SECRETARY
890 RIGEWOOD RD
WADSWORTH OH 44281

Officer/Director/Trustee Five

MATHEW BECK
TREASURER
675 ALPHA PARK DR
HIGHLAND HTS OH 44143

Organization’s website MINDBODYSOULSURVIVOR.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/2/2020
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F99 - Mental Health, Crisis Intervention 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 No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name MICHELLE BOND
Signature Title DIRECTOR
Signature Date 10/17/2020

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