FORM 1023-EZ for MEIS DENTAL EDUCATION LEGACY INC

Field Data
EIN 86-3688524
Case Number EO-2021237-000403
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MEIS DENTAL EDUCATION LEGACY INC
Organization’s Mailing Address 522 4TH STREET SUITE 200
City SIOUX CITY
State IA
ZIP 51101
Accounting period End 12
Primary contact name ERIC GILBERTSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOHN MEIS
BOARD PRESIDENT
10532 N CRESTVIEW DR
FOUNTAIN HILLS AZ 85268

Officer/Director/Trustee Two

KAREN SKOREY-CHICOINE
TREASURER
2421 W SOLWAY ST
SIOUX CITY IA 51104

Officer/Director/Trustee Three

WENDY BRIGGS
BOARD MANAGING DIRECTOR
33 E SIENA DR
PLEASANT GROVE UT 84062

Officer/Director/Trustee Four

ANNA KIMBALL
BOARD SECRETARY
10510 N SUGARLOAF DR
CEDAR HILLS UT 84062

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/5/2021
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B12 - Fund Raising and/or Fund Distribution
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 Yes
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers Yes
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 KAREN SKOREY-CHICOINE
Signature Title TREASURER
Signature Date 8/23/2021

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