FORM 1023-EZ for A MOMENT FOR YOUR COMMUNITY INC

Field Data
EIN 85-2558814
Case Number EO-2020233-000358
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name A MOMENT FOR YOUR COMMUNITY INC
Organization’s Mailing Address 10021 SW 182ND CIR
City DUNNELLON
State FL
ZIP 34432
Accounting period End 12
Primary contact name SUSAN LEE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SUSAN LEE
PRESIDENT / DIRECTOR
10021 SW 182ND CIR
DUNNELLON FL 34432

Officer/Director/Trustee Two

EDITH WEBBER
TREASURER / SECRETARY
10021 SW 182ND CIR
DUNNELLON FL 34432

Officer/Director/Trustee Three

MELANIE BARKER
DIRECTOR
10021 SW 182ND CIR
DUNNELLON FL 34432

Officer/Director/Trustee Four

KATHRYN HOWARD
DIRECTOR
10021 SW 182ND CIR
DUNNELLON FL 34432

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/14/2020
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
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 SUSAN LEE
Signature Title PRESIDENT / DIRECTOR
Signature Date 8/18/2020

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