FORM 1023-EZ for MISSION ONE LTD

Field Data
EIN 83-3002586
Case Number EO-2019031-000759
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MISSION ONE LTD
Organization’s Mailing Address 11930 W 103RD CT
City ST JOHN
State IN
ZIP 46373-9588
Accounting period End 11
Primary contact name JOHN BOERSMA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID MILLER
CHAIRMAN
12810 LEE CT
CEDAR LAKE IN 46303

Officer/Director/Trustee Two

KENNETH CMELO
VICE-CHAIRMAN
1644 NOVO DR
SCHERERVILLE IN 46375

Officer/Director/Trustee Three

MICHELLE MCCORMICK
SECRETARY
9814 WILDWOOD CT 2B
HIGHLAND IN 46322

Officer/Director/Trustee Four

KATHLEEN BOERSMA
TREASURER
11930 W 103RD CT
SAINT JOHN IN 46373-9588

Officer/Director/Trustee Five

JOHN BOERSMA
CHIEF EXECUTIVE OFFICER
11930 W 103RD CT
SAINT JOHN IN 46373-9588

Organization’s website
Organization’s email Johnnieb71@gmail.com
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/26/18
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W30 - Military, Veterans' Organizations
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 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 JOHN BOERSMA
Signature Title CHIEF EXECUTIVE OFFICER
Signature Date 1/6/19

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