FORM 1023-EZ for MOMA

Field Data
EIN 83-3477110
Case Number EO-2020209-000489
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MOMA
Organization’s Mailing Address 160 20TH ST APT 14
City SPRINGFIELD
State OR
ZIP 97477
Accounting period End 12
Primary contact name THOMAS J DAVIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

THOMAS J DAVIS
PRESIDENT
160 20TH ST APT 14
SPRINGFIELD OR 97477

Officer/Director/Trustee Two

CHAD ZISLER
SECRETARY
1252 WARNER ST APT 5
CHICO CA 95926

Officer/Director/Trustee Three

THOMAS DAVIS
DIRECTOR
1885 S BARTLETT RD
ST CLAIR MI 48079

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/7/2019
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code C36 - Forest Conservation
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 No
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 THOMAS J DAVIS
Signature Title PRESIDENT
Signature Date 7/20/2020

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