FORM 1023-EZ for TWO 12 SYCAMORE

Field Data
EIN 82-0876348
Case Number EO-2017102-000137
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TWO 12 SYCAMORE
Organization’s Mailing Address 170 ENGLISH LANDING DRIVE STE 231A
City PARKVILLE
State MO
ZIP 64152
Accounting period End 12
Primary contact name KENNETH WILSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KENNETH WILSON
PRESIDENT/CEO
170 ENGLISH LANDING DR STE 231A
PARKVILLE MO 64152

Officer/Director/Trustee Two

DON BODEMANN
VICE-PRESIDENT
101 VALLEY VIEW
HOT SPRINGS AR 71901

Officer/Director/Trustee Three

SHELBY BAUER
TREASURER
1365 2000TH STREET
IOLA KS 66749

Officer/Director/Trustee Four

JOHN SHETLAR
SECRETARY
148 FAIRDALE RD
SALINA KS 67401

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/3/2017
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W12 - Fund Raising and/or Fund Distribution
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 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
Signature Title
Signature Date

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