FORM 1023-EZ for DIRENNA FOUNDATION FOR THE ADVANCEMENT OF OSTEOPATHIC FAMILY MEDICINE

Field Data
EIN 84-1930164
Case Number EO-2019154-000282
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DIRENNA FOUNDATION FOR THE ADVANCEMENT OF OSTEOPATHIC FAMILY MEDICINE
Organization’s Mailing Address 1601 GREEN BERRY ROAD
City JEFFERSON CITY
State MO
ZIP 65101
Accounting period End 12
Primary contact name PAMELA COCHRAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHRISTOPHER PAYNTER
PRESIDENT
1601 GREEN BERRY ROAD
JEFFERSON CITY MO 65101

Officer/Director/Trustee Two

IAN FAWKS
PRESIDENT ELECT
1601 GREEN BERRY ROAD
JEFFERSON CITY MO 65101

Officer/Director/Trustee Three

ALAN BREWER
SECRETARY TREASURER
1601 GREEN BERRY ROAD
JEFFERSON CITY MO 65101

Officer/Director/Trustee Four

C MARK ROSE
DIRECTOR
1601 GREEN BERRY ROAD
JEFFERSON CITY MO 65101

Officer/Director/Trustee Five

BENJAMIN REINE
DIRECTOR
1601 GREEN BERRY ROAD
JEFFERSON CITY MO 65101

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/20/18
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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 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 CHRISTOPHER PAYNTER
Signature Title PRESIDENT
Signature Date 5/30/19

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