FORM 1023-EZ for MODUS VIVENDI INC
| Field | Data |
|---|---|
| EIN | 84-2019950 |
| Case Number | EO-2019192-000329 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | MODUS VIVENDI INC |
| Organization’s Mailing Address | 125 NORTH 16TH STREET |
| City | MAMMOTH SPRING |
| State | AR |
| ZIP | 72554 |
| Accounting period End | 12 |
| Primary contact name | JEFF D WELCH |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
MARY A RAGSDALE
EXECUTIVE DIRECTOR
125 NORTH 16TH STREET
MAMMOTH SPRING AR 72554
Officer/Director/Trustee Two
TERRY CROCKETT
PRESIDENT OF BOARD
125 NORTH 16TH STREET
MAMMOTH SPRING AR 72554
Officer/Director/Trustee Three
DEANNA DECKARD
SECRETARY
216 SOUTH 10TH ST
THAYER MO 65791
Officer/Director/Trustee Four
CHARLA SHRABLE
VICE PRESIDENT
395 W WORTH RD
MAMMOTH SPRING AR 72554
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 6/7/19 |
| Organization Incorporation State | AR |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | P20 - Human Service Organizations - Multipurpose |
| 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 | 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 | 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 | MARY A RAGSDALE |
| Signature Title | EXECUTIVE DIRECTOR |
| Signature Date | 7/9/19 |
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