FORM 1023-EZ for MBSS-MIND BODY SOUL SPIRIT MINISTRIES INC

Field Data
EIN 84-4089086
Case Number EO-2021063-000801
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MBSS-MIND BODY SOUL SPIRIT MINISTRIES INC
Organization’s Mailing Address 2915 SAM HICKS ROAD
City PLANY CITY
State FL
ZIP 33567
Accounting period End 12
Primary contact name SHERYLL Y BROADNAX
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHERYLL BROADNAX
CHIEF EXECUTIVE OFFICER
2915 SAM HICKS ROAD
PLANY CITY FL 33567

Officer/Director/Trustee Two

NATALIE WALKER
TREASURER
421 STONE CREST AVE
BOWLING GREEN KY 42101

Officer/Director/Trustee Three

FLORENCE INGRAHAM-CLARK
SECRETARY
4614 HORTON ROAD
PLANT CITY FL 33567

Officer/Director/Trustee Four

ANTOINETTE GATEWOOD
DIRECTOR
18040 ANNES CIR UNIT 104
CANYON COUNTRY CA 91387

Officer/Director/Trustee Five

BARBARA INGRAHAM-LUCY
DIRECTOR
3355 FORT SUMTER ST
MELBOURNE FL 32934

Organization’s website
Organization’s email MBSSMINISTRIES@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/20/2019
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X99 - Religion Related, Spiritual Development N.E.C.
Organization’s purpose Charitable: Yes
Religious: Yes
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 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 SHERYLL BROADNAX
Signature Title CHIEF EXECUTIVE OFFICER
Signature Date 12/30/2020

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