FORM 1023-EZ for THE BARBARA ROBINETTE MOSS FOUNDATION

Field Data
EIN 83-2051973
Case Number EO-2018290-000284
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE BARBARA ROBINETTE MOSS FOUNDATION
Organization’s Mailing Address 21921 S WALNUT BLUFF ROAD
City PLEASANT HILL
State MO
ZIP 64080
Accounting period End 12
Primary contact name NATHAN THOMAS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KRISTINE CLOUGHLEY
PRESIDENT/BOARD MEMBER
21921 S WALNUT BLUFF ROAD
PLEASANT HILL MO 64080

Officer/Director/Trustee Two

PATRICIA LEWIS
TREASURER/BOARD MEMBER
814 W 54TH TERRACE
KANSAS CITY MO 64112

Officer/Director/Trustee Three

DUANNE DERAAD
SECRETARY/BOARD MEMBER
18 COMANCH ROAD
EL PRADO NM 87529

Officer/Director/Trustee Four

TIFFANY CHRISTIANSEN
BOARD MEMBER
7605 MAPLE
PRAIRIE VILLAGE KS 66208

Officer/Director/Trustee Five

RYAN PETERS
BOARD MEMBER
1618 W 27TH TERRACE
LAWRENCE KS 66046

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/24/18
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W99 - Public, Society Benefit - Multipurpose and Other N.E.C.
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: Yes
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 KRISTINE CLOUGHLEY
Signature Title PRESIDENT/BOARD MEMBER
Signature Date 10/15/18

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