FORM 1023-EZ for CR38V3 M1ND5

Field Data
EIN 84-4401181
Case Number EO-2020037-000182
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CR38V3 M1ND5
Organization’s Mailing Address 101 ARBOR SPRINGS LANE
City DICKINSON
State TX
ZIP 77539-6147
Accounting period End 1
Primary contact name SEANDA BLOCKER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SEANDA BLOCKER
EXECUTIVE DIRECTOR
101 ARBOR SPRINGS LANE
DICKINSON TX 77539-6147

Officer/Director/Trustee Two

KIMBERLY BREEDLOVE
TREASURER, DIRECTOR
3835 FM 226
NACOGDOCHES TX 75961

Officer/Director/Trustee Three

MINNIE BIRDSONG
SECRETARY, DIRECTOR
800 CR SW 3230
WINNSBORO TX 75494

Officer/Director/Trustee Four

CHARLOTTE ROGERS
DIRECTOR
PO BOX 1043
MT. VERNON TX 75457

Officer/Director/Trustee Five

MICHAEL CRAMER
DIRECTOR
426 SAN GABRIEL DRIVE
SUNNYVALE TX 75182

Organization’s website
Organization’s email CR38V3M1ND5@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/21/2020
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E60 - Health Support Services
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 SEANDA BLOCKER
Signature Title EXECUTIVE DIRECTOR
Signature Date 2/4/2020

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