FORM 1023-EZ for ROOTED INC

Field Data
EIN 30-1213501
Case Number EO-2019360-000251
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ROOTED INC
Organization’s Mailing Address 924 N A STREET
City ARKANSAS CITY
State KS
ZIP 67005
Accounting period End 12
Primary contact name LORY WEST
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LORY WEST
DIRECTOR
924 N A STREET
ARKANSAS CITY KS 67005

Officer/Director/Trustee Two

LESLIE NEWMAN
DIRECTOR
406 N C STREET
ARKANSAS CITY KS 67005

Organization’s website ROOTEDWOMENSMINISTRY.COM
Organization’s email LORYWEST5@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/24/2019
Organization Incorporation State KS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P50 - Personal Social Services
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 LORY WEST
Signature Title DIRECTOR
Signature Date 12/23/2019

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