FORM 1023-EZ for MANIFESTED MERCY

Field Data
EIN 81-5310446
Case Number EO-2018290-000335
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MANIFESTED MERCY
Organization’s Mailing Address 1305 S RODGERS AVE
City ALTON
State IL
ZIP 62002-3007
Accounting period End 12
Primary contact name JASON KELLEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JASON KELLEY
FOUNDER/OWNER
1305 S RODGERS AVE
ALTON IL 62002-3007

Officer/Director/Trustee Two

TINA KELLEY
FOUNDER/OWNER
1305 S RODGERS AVE
ALTON IL 62002-3007

Officer/Director/Trustee Three

LORI GARVIN
BOARD MEMBER
219 DOERR ST
ROXANA IL 62084-1111

Organization’s website WWW.MANIFESTEDMERCY.COM
Organization’s email TINAJPK112015@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/15/18
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 Yes
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 No
Correctness Declaration Yes
Signature Name TINA KELLEY
Signature Title FOUNDER/OWNER
Signature Date 10/15/18

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