FORM 1023-EZ for FM BREAST FRIENDS

Field Data
EIN 47-4791532
Case Number EO-2016034-000084
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FM BREAST FRIENDS
Organization’s Mailing Address 3911 WESTMOOR DRIVE
City MOORHEAD
State MN
ZIP 56560
Accounting period End 12
Primary contact name KRYSTAL ANDERSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KRYSTAL ANDERSON
CO-PRESIDENT
7409 OAK COURT
HORACE ND 58047

Officer/Director/Trustee Two

STEPHENIE HERBRANSON
CO-PRESIDENT
3911 WESTMOOR DRIVE
MOORHEAD MN 56560

Officer/Director/Trustee Three

KRISTIN ERICKSON
VICE PRESIDENT
7819 15TH ST S
FARGO ND 58104

Officer/Director/Trustee Four

JANELL MEIER
TREASURER
4354 58TH ST S
FARGO ND 58104

Officer/Director/Trustee Five

JAN WUTZKE
SECRETARY
1525 7TH ST S
FARGO ND 58103

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/14/2015
Organization Incorporation State ND
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W11 - Single Organization Support
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 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 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
Signature Title
Signature Date

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