FORM 1023-EZ for SURVIVE THRIVE

Field Data
EIN 47-3391282
Case Number EO-2015110-000293
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SURVIVE THRIVE
Organization’s Mailing Address 9003 E 87 ST
City RAYTOWN
State MO
ZIP 64138
Accounting period End 1
Primary contact name BECKY ADNEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

BECKY ADNEY
PRESIDENT
12801 E 49 ST S
INDEPENDENCE MO 64055

Officer/Director/Trustee Two

BELINDA BAKER
VICE PRESIDENT
8509 ARLINGTON
RAYTOWN MO 64138

Officer/Director/Trustee Three

GINETTE RITTER
SECRETARY
9108 E 89 ST
KANSAS CITY MO 64138

Officer/Director/Trustee Four

THERESA BRDIGES
TREASURER
7700 WALLACE
KANSAS CITY MO 64138

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/23/2015
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P42 - Single Parent Agencies, Services
Organization’s purpose Charitable: No
Religious: Yes
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 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
Signature Title
Signature Date

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