FORM 1023-EZ for HIGHWAY MISSIONARY INC

Field Data
EIN 81-4990331
Case Number EO-2018346-000259
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HIGHWAY MISSIONARY INC
Organization’s Mailing Address 3523 GREEN DALE DR UNIT 9
City ROCKFORD
State IL
ZIP 61109
Accounting period End 12
Primary contact name RALPH DAER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RALPH DAER
PRESIDENT, DIRECTOR
PO BOX 408
PRAIRIE DU CHEIN WI 53821

Officer/Director/Trustee Two

DARREN HUCKINS
SECRETARY, DIRECTOR
29942 141ST ST APT 16
MCGREGOR IA 52157

Officer/Director/Trustee Three

JACQUELYN ZASLAVSKY
TREASURER, DIRECTOR
PO BOX 2873
LOVES PARK IL 61132

Organization’s website WWW.HIGHWAYMISSIONARY.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/13/18
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 Yes
Donation of funds Yes
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 RALPH DAER
Signature Title PRESIDENT, DIRECTOR
Signature Date 12/10/18

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