FORM 1023-EZ for J MARK SUSAN HOLBROOK MINISTRIES

Field Data
EIN 82-4962299
Case Number EO-2018106-000333
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name J MARK SUSAN HOLBROOK MINISTRIES
Organization’s Mailing Address 207 S LIBERTY ST
City WEST UNITY
State OH
ZIP 43570
Accounting period End 12
Primary contact name VICTOR N TEN BRINK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

J MARK HOLBROOK
PRESIDENT/DIRECTOR
207 S LIBERTY ST
WEST UNITY OH 43570

Officer/Director/Trustee Two

LEONARD ROESSLER
DIRECTOR
18879 COUNTY RD 15
BLUFFTON OH 45817

Officer/Director/Trustee Three

KURTIS MOORE
DIRECTOR
518 N MYERS ST
BRYAN OH 43506

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/13/18
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: Yes
Religious: Yes
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 J MARK HOLBROOK
Signature Title PRESIDENT/DIRECTOR
Signature Date 4/10/18

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