FORM 1023-EZ for TEENS ON A MISSION

Field Data
EIN 47-3042505
Case Number EO-2017299-000371
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TEENS ON A MISSION
Organization’s Mailing Address 5122 VERNON AVENUE
City SAINT LOUIS
State MO
ZIP 63113
Accounting period End 7
Primary contact name MELYNIE BLACKSHEAR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MELYNIE BLACKSHEAR
PRESIDENT
5122 VERNON AVENUE
SAINT LOUIS MO 63113

Officer/Director/Trustee Two

GWYNNETTE JACKSON
TREASURER
3151 NEBRASKA AVENUE
SAINT LOUIS MO 63118

Officer/Director/Trustee Three

MARILYN DILWORTH
SECRETARY
11800 NEW HALLS FERRY
FLORISSANT MO 63033

Organization’s website WWW.TEENSONAMISSION.ORG
Organization’s email TOM@TEENSONAMISSION.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/9/2015
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: Yes
Religious: No
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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date
EIN 47-3042505
Case Number EO-2015064-000225
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TEENS ON A MISSION
Organization’s Mailing Address 5122 VERNON AVENUE
City SAINT LOUIS
State MO
ZIP 63113
Accounting period End 2
Primary contact name MELYNIE BLACKSHEAR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MELYNIE BLACKSHEAR
DIRECTOR
5122 VERNON AVENUE
SAINT LOUIS MO 63113

Organization’s website
Organization’s email MELYNIE75@YAHOO.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/9/2015
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural 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 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
Signature Title
Signature Date

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