FORM 1023-EZ for OUR LADY OF THE HOLY ROSARY SHRINE INC

Field Data
EIN 47-5245764
Case Number EO-2017215-000036
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name OUR LADY OF THE HOLY ROSARY SHRINE INC
Organization’s Mailing Address 7762 RICHARDSON ROAD
City BONNE TERRE
State MO
ZIP 63628
Accounting period End 12
Primary contact name MARY BROOME
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARY BROOME
PRESIDENT
7762 RICHARDSON ROAD
BONNE TERRE MO 63628

Officer/Director/Trustee Two

RICHARD BROOME
TREASURER
7762 RICHARDSON ROAD
BONNE TERRE MO 63628

Officer/Director/Trustee Three

LINDA SCROGIN
SECRETARY
607 BARBARA LANE
BONNE TERRE MO 63628

Officer/Director/Trustee Four

MARTHA HERMANN
DIRECTOR
733 PARKWOOD DRIVE APT 234
SAINT GENEVIEVE MO 63670

Officer/Director/Trustee Five

TOM WILLETTE
DIRECTOR
206 MANOR DRIVE
BONNE TERRE MO 63628

Organization’s website
Organization’s email MLBROOME1@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/8/2011
Organization Incorporation State MO
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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