FORM 1023-EZ for DR LARRY K WIGGINS FAMILY MUSEUM REVOCABLE LIVING TRUST

Field Data
EIN 81-4499412
Case Number EO-2017317-000465
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DR LARRY K WIGGINS FAMILY MUSEUM REVOCABLE LIVING TRUST
Organization’s Mailing Address 910 NORTH CLAY STREET
City MEMPHIS
State MO
ZIP 63555
Accounting period End 12
Primary contact name CAROLYN KAY EGGLESTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LARRY K WIGGINS
PRESIDENT
910 NORTH CLAY STREET
MEMPHIS MO 63555

Officer/Director/Trustee Two

SALLY PLOWMAN
SECRETARY
570 ROCK CREEK DRIVE
WASHINGTON MO 63090

Officer/Director/Trustee Three

DAVID WIGGINS
VICE PRESIDENT
13453 STATE ROUTE D
MEMPHIS MO 63555

Officer/Director/Trustee Four

MARK WIGGINS
DIRECTOR
7 BLUFF HILLS ROAD
MONTROSE IA 52639

Organization’s website
Organization’s email
Organization Incorporated
Organization trust Yes
Necessary Organizing Documents Yes
Organization Incorporation Date 12/7/2016
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A50 - Museum, Museum Activities
Organization’s purpose Charitable: Yes
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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