FORM 1023-EZ for BREATHE AND BELIEVE INC

Field Data
EIN 84-2921957
Case Number EO-2020006-000200
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BREATHE AND BELIEVE INC
Organization’s Mailing Address 1819 VIZALEEA DR
City DUBUQUE
State IA
ZIP 52002
Accounting period End 12
Primary contact name KELLIE J COOK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KELLIE COOK
DIRECTOR
1819 VIZALEEA DR
DUBUQUE IA 52002

Officer/Director/Trustee Two

KRISSY MUELLER
BOARD MEMBER
1204 ADELINE DR
DUBUQUE IA 52003

Officer/Director/Trustee Three

CALLY BURKLE
BOARD MEMBER
185 MAIN ST APT 2
DUBUQUE IA 52001

Organization’s website WWW.BREATHEANDBELIEVEYOGAOUTREACH.COM
Organization’s email KELLIECOOKYOGA@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/3/2019
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W99 - Public, Society Benefit - Multipurpose and Other N.E.C.
Organization’s purpose Charitable: No
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 Yes
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 KELLIE COOK
Signature Title DIRECTOR
Signature Date 1/1/2020

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