FORM 1023-EZ for MISSION ST LUKE INC

Field Data
EIN 47-2731928
Case Number EO-2016179-000271
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MISSION ST LUKE INC
Organization’s Mailing Address 3001 MOTLEY DRIVE STE A
City MESQUITE
State TX
ZIP 75150
Accounting period End 12
Primary contact name JAMES R RAWLS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JAMES RAWLS
PRESIDENT
3001 MOTLEY DRIVE STE A
MESQITE TX 75150

Officer/Director/Trustee Two

ROBERT RAWLS
SECRETARY TREASURER
6900 NE 101ST
OKLAHOMA CITY OK 73151

Officer/Director/Trustee Three

BYRON MCNIGHT
VICE PRESIDENT
3319 TOWN CROSSING STE 205
MESQUITE TX 75150

Officer/Director/Trustee Four

TED FOGWELL
DIRECTOR
7131 STEFANI DRIVE
DALLAS TX 75225

Officer/Director/Trustee Five

DEBI HOLLEY
DIRECTOR
442 EAST TRIPP ROAD
SUNNYVALE TX 75182

Organization’s website MISSIONSTLUKE.ORG
Organization’s email RRAWLS1@SBCGLOBAL.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/2015
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E99 - Health - General and Rehabilitative N.E.C.
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
Signature Title
Signature Date

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