FORM 1023-EZ for MIDWEST HEALTH RESOURCES

Field Data
EIN 47-4365090
Case Number EO-2016147-000220
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MIDWEST HEALTH RESOURCES
Organization’s Mailing Address 287 125TH ST NE
City RICE
State MN
ZIP 56367
Accounting period End 12
Primary contact name DEBORAH GAZETT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DEBORAH GAZETT
PRESIDENT
287 125TH ST NE
RICE MN 56367

Officer/Director/Trustee Two

GREGORY GAZETT
VICE PRESIDENT
287 125TH ST NE
RICE MN 56367

Officer/Director/Trustee Three

JEANETTE AYO
SECRETARY
6889 CLEARWATER RD APT 114
BAXTER MN 56425

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/26/2015
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: No
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 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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