FORM 1023-EZ for ROLLA CANNABIS ACTION NETWORK

Field Data
EIN 85-2072777
Case Number EO-2020234-000277
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ROLLA CANNABIS ACTION NETWORK
Organization’s Mailing Address 11480 PRIVATE DR 2048
City ROLLA
State MO
ZIP 65401
Accounting period End 12
Primary contact name SAMARA WEBBER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHIRLEY MARTIN
CEO
11480 PRIVATE DR 2048
ROLLA MO 65401

Officer/Director/Trustee Two

TRISTAN DUNLAP
CFO
11251 PINEDALE DR
ROLLA MO 65401

Officer/Director/Trustee Three

LINDA SNODGRASS
TREASURER
28625 COUNTY RD 6215
EDGAR SPRINGS MO 65462

Officer/Director/Trustee Four

DESTINY THOMPSON
SECRETARY / DIRECTOR OF PR
2136 TENBRINK DR
ROLLA MO 65401

Officer/Director/Trustee Five

MARY ROLUFS
DIRECTOR OF SOCIAL MEDIA
10125 COUNTY RD 2020
ROLLA MO 65401

Organization’s website HTTPS://WWW.FACEBOOK.COM/ROLLACANNAACTIONNETWORK/
Organization’s email ROLLACANNABISACTIONNETWORK@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/11/2020
Organization Incorporation State MO
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 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 No
Correctness Declaration Yes
Signature Name SHIRLEY MARTIN
Signature Title CEO
Signature Date 8/19/2020

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