FORM 1023-EZ for PATCHWORK MEMORY BRIDGES INC

Field Data
EIN 47-3792832
Case Number EO-2015226-000244
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PATCHWORK MEMORY BRIDGES INC
Organization’s Mailing Address 5155 MARTINIQUE DR
City LAKELAND
State FL
ZIP 33812
Accounting period End 6
Primary contact name MARTHA BELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

FRANCES MORRIS
BOARD CHAIR
5155 MARTINIQUE DR
LAKELAND FL 33812

Officer/Director/Trustee Two

RON DANIEL
BOARD VICE CHAIR
6866 CRESCENT OAKS CIR
LAKELAND FL 33813

Officer/Director/Trustee Three

CINDY CHOUSE
SECRETARY OF BOARD
1648 DOVES VIEW CIRCLE
AUBURNDALE FL 33823

Officer/Director/Trustee Four

MARTHA BELL
BOARD TREASURER
215 IMPERIAL BL ST B-1
LAKELAND FL 33803

Organization’s website WWW.MEMORYBRIDGES.COM
Organization’s email FRAN@MEMORYBRIDGES.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/21/2015
Organization Incorporation State FL
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 Yes
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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