FORM 1023-EZ for MAXWELL THEATRICAL SELF IMAGE INC

Field Data
EIN 41-2202341
Case Number EO-2020273-000884
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MAXWELL THEATRICAL SELF IMAGE INC
Organization’s Mailing Address 1910 ORIE DR
City COLUMBIA
State MO
ZIP 65202-6021
Accounting period End 1
Primary contact name ELVIRA MAXWELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ELVIRA MAXWELL
CEO AND PRESIDENT
1910 ORIE DR
COLUMBIA MO 65202-6021

Officer/Director/Trustee Two

SENJIA BROWN
SECRETARY
16104 E ALASKA PL UNIT D
AURORA CO 80017

Officer/Director/Trustee Three

JOHN MAXWELL
TREASURER
1910 ORIE DR
COLUMBIA MO 65202-6021

Organization’s website
Organization’s email MAXWELLTHEATRICAL@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/28/2019
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Z99 - Unclassified
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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 Yes
Correctness Declaration Yes
Signature Name ELVIRA MAXWELL
Signature Title CEO AND PRESIDENT
Signature Date 9/25/2020

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