FORM 1023-EZ for THE MINDFUL GAME NFP

Field Data
EIN 47-5025008
Case Number EO-2015257-000407
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE MINDFUL GAME NFP
Organization’s Mailing Address 523 MONROE AVE
City SAINT CHARLES
State IL
ZIP 60174-3040
Accounting period End 12
Primary contact name TRACY HEILERS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TRACY HEILERS
PRESIDENT, SECRETARY, TREASURER
523 MONROE AVE
SAINT CHARLES IL 60174-3040

Officer/Director/Trustee Two

GARY HEILERS
VICE PRESIDENT
523 MONROE AVE
SAINT CHARLES IL 60174-3040

Officer/Director/Trustee Three

JUDITH WALZ
DIRECTOR
5130 E PHELPS ROAD
SCOTTSDALE AZ 85254

Organization’s website
Organization’s email TRACYHEILERS@ICLOUD.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/8/2015
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N20 - Recreational and Sporting Camps
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 Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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