FORM 1023-EZ for MOMS ON A MISSION INC

Field Data
EIN 81-3794377
Case Number EO-2016273-000453
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MOMS ON A MISSION INC
Organization’s Mailing Address 12413 CEDARFIELD DR
City RIVERVIEW
State FL
ZIP 33579
Accounting period End 12
Primary contact name NATASHIA SHANNON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NATASHIA SHANNON
PRESIDENT
12413 CEDARFIELD DR
RIVERVIEW FL 33579

Officer/Director/Trustee Two

JOAI BROUGHTON
VICE PRESIDENT
518 SCARLET MAPLE CT
PLANT CITY FL 33563

Officer/Director/Trustee Three

HEATHER LEIGH
SECRETARY TREASURER
520 NE 82ND TERRACE UNIT 6
MIAMI FL 33138

Officer/Director/Trustee Four

NICHOLAS HORNER
AUTHORIZED REPRESENTATIVE
100 N TAMPA STREET SUITE 2700
TAMPA FL 33602

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/1/2016
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P51 - Financial Counseling, Money Management
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 Yes
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts Yes
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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