FORM 1023-EZ for WESTERN BLUECOATS FIELD HOSPITAL INC

Field Data
EIN 46-5401334
Case Number EO-2014357-000023
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name WESTERN BLUECOATS FIELD HOSPITAL INC
Organization’s Mailing Address 2008 KARLTON WAY
City EXCELSIOR SPRINGS
State MO
ZIP 64024-1694
Accounting period End 12
Primary contact name THOMAS LUMPKINS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

THOMAS LUMPKINS
PRESIDENT
2008 KARLTON WAY
EXCELSIOR SPRINGS MO 64024-1694

Officer/Director/Trustee Two

GARRETT LOVELL
VICE PRESIDENT
15550 S BLACKFEATHER ST
OLATHE KS 66062-3681

Officer/Director/Trustee Three

CYNTHIA RESIG
TREASURER
11221 W 67TH TERRACE
SHAWNEE KS 66203-3701

Officer/Director/Trustee Four

TIFFANY LUMPKINS
SECRETARY
2008 KARLTON WAY
EXCELSIOR SPRINGS MO 64024-1694

Organization’s website HTTP://BLUECOATHOSPITAL.WIX.COM/MEDICAL
Organization’s email DRLUMPKINS@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/14/2014
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A80 - Historical Societies, Related Historical Activities
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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
Signature Title
Signature Date

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