FORM 1023-EZ for NOVGOROD RUSSIA MISSION OUTREACH

Field Data
EIN 81-1026318
Case Number EO-2016025-000153
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NOVGOROD RUSSIA MISSION OUTREACH
Organization’s Mailing Address 605 N 3D STREET
City ROANOKE
State IL
ZIP 61561
Accounting period End 12
Primary contact name CLARENCE HUGHES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CLARENCE HUGHES
DIRECTOR
605 N 3D STREET
ROANOKE IL 61561

Officer/Director/Trustee Two

CAROL HUGHES
DIRECTOR
605 N 3D STREET
ROANOKE IL 61561

Officer/Director/Trustee Three

RONALD JONES
DIRECTOR
1364 MT ZION ROAD
EUREKA IL 61530

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/8/2015
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X11 - Single Organization Support
Organization’s purpose Charitable: Yes
Religious: Yes
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 Yes
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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