FORM 1023-EZ for MOVE FOR MILES CHILDHOOD CANCER FOUNDATION INC

Field Data
EIN 82-2953009
Case Number EO-2017275-000672
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MOVE FOR MILES CHILDHOOD CANCER FOUNDATION INC
Organization’s Mailing Address 206 E 9TH ST STE 1300
City AUSTIN
State TX
ZIP 78701
Accounting period End 12
Primary contact name STEPHANIE DAGELEWICZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

STEPHANIE DAGELEWICZ
PRESIDENT CEO
PO BOX 250335
PLANO TX 75025

Officer/Director/Trustee Two

JASON DAGELEWICZ
CHEIF OPERATING OFFICER
PO BOX 250335
PLANO TX 75025

Officer/Director/Trustee Three

RACHEL WILCOX
DIRECTOR
521 PARKVIEW PLACE
COPPELL TX 75019

Officer/Director/Trustee Four

CRISTIN LAVELLE GOERKE
DIRECTOR
723 MANGROVE POINT RD
SARASOTA FL 34242

Officer/Director/Trustee Five

GUY BELLAVER
DIRECTOR
2220 S HARWOOD UNIT 205
DALLAS TX 75215

Organization’s website HTTPS://MOVEFORMILES.ORG
Organization’s email STEPHANIE@MOVEFORMILES.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/28/2017
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: Yes
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 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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