FORM 1023-EZ for MISSIO DEI

Field Data
EIN 30-0965530
Case Number EO-2017065-000357
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MISSIO DEI
Organization’s Mailing Address 14985 HIMEBAUGH AVE
City OMAHA
State NE
ZIP 68116
Accounting period End 12
Primary contact name ROBERT HOLTROP
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PETER MATT
DIRECTOR
1506 S 122ND ST
OMAHA NE 68144

Officer/Director/Trustee Two

TOM STARKJOHN
DIRECTOR
5313 LUV RD
PLATTSMOUTH NE 68048

Officer/Director/Trustee Three

MIKE SCECHLER
DIRECTOR
821 E FULTON AVE
OAKLAND NE 68045

Officer/Director/Trustee Four

ROBERT HOLTROP
PRESIDENT
14985 HIMEBAUGH AVE
OMAHA NE 68116

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/10/2017
Organization Incorporation State NE
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: No
Religious: Yes
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
Signature Title
Signature Date

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