FORM 1023-EZ for MUNSHA PSYCHIATRIC FOUNDATION INC

Field Data
EIN 47-5303025
Case Number EO-2015341-000532
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MUNSHA PSYCHIATRIC FOUNDATION INC
Organization’s Mailing Address 3007 COTTONWOOD HILL DRIVE
City NEWTON
State KS
ZIP 67114
Accounting period End 12
Primary contact name MWENDALUBI YASA MD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MWENDALUBI YASA
PRESIDENT
3007 COTTONWOOD HILL DRIVE
NEWTON KS 67114

Officer/Director/Trustee Two

PERPETUAL MURRAY
SECRETARY
18820 PEBBLE LINKS CIRCLE 303
TAMPA FL 33647

Officer/Director/Trustee Three

DANNY MURRAY
BOARD MEMBER
18820 PEBBLE LINKS CIRCLE 303
TAMPA FL 33647

Officer/Director/Trustee Four

GAYLYNN SECRIST
TREASURER
3505 MALINA PLACE
KIHEI HI 96753

Officer/Director/Trustee Five

MAKALU CHINONGE
BOARD MEMBER
28417 15TH PLACE S
FEDERAL WAY WA 98003

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/10/2015
Organization Incorporation State KS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F30 - Mental Health Treatment - Multipurpose and N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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 Yes
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
Signature Title
Signature Date

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