FORM 1023-EZ for LEADERSHIP MITCHELL COUNTY INC

Field Data
EIN 84-4395197
Case Number EO-2020034-000067
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LEADERSHIP MITCHELL COUNTY INC
Organization’s Mailing Address 116 N HERSEY AVE PO BOX 369
City BELOIT
State KS
ZIP 67420-0369
Accounting period End 5
Primary contact name CURTIS A FRASIER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ERIC HILT
PRESIDENT
710 N HERSEY AVE
BELOIT KS 67420

Officer/Director/Trustee Two

MARK PALEN
TREASURER
800 N CAMPBELL AVE
BELOIT KS 67420

Officer/Director/Trustee Three

JASON RABE
SECRETARY
723 N CAMPBELL AVE
BELOIT KS 67420

Officer/Director/Trustee Four

CURTIS FRASIER
DIRECTOR
116 N HERSEY AVE
BELOIT KS 67420

Officer/Director/Trustee Five

COLLEEN EBERLE
DIRECTOR
802 13TH STREET
CAWKER CITY KS 67430

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/26/2019
Organization Incorporation State KS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W70 - Leadership Development
Organization’s purpose Charitable: Yes
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 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 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 CURTIS FRASIER
Signature Title DIRECTOR
Signature Date 1/30/2020

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