FORM 1023-EZ for NSMBC COMMUNITY OUTREACH MISSION INCORPORATED

Field Data
EIN 55-0893976
Case Number EO-2016308-000205
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NSMBC COMMUNITY OUTREACH MISSION INCORPORATED
Organization’s Mailing Address 4700 WEST FLORISSANT AVENUE
City ST. LOUIS
State MO
ZIP 63115-2234
Accounting period End 12
Primary contact name STEPHANIE HEMPHILL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANTHONY RICKS
PRESIDENT BOARD CHAIRMAN
19 COUNTRY LANE COURT
FLORISSANT MO 63033-8521

Officer/Director/Trustee Two

STEPHANIE HEMPHILL
SECRETARY/CONTROLLER TRUSTEE
5106 MIDDAY DRIVE
FLORISSANT MO 63033-8521

Officer/Director/Trustee Three

REV BRANDON BLAKE
PASTOR BOARD OF DIRECTORS
4954 NOEL MISSION DR
MEMPHIS TN 38125-4783

Officer/Director/Trustee Four

MICKEY THOMAS
BOARD OF DIRECTORS
11591 PATTY ANN DRIVE
CREVE COEUR MO 63146-5454

Officer/Director/Trustee Five

LENO BLUE
BOARD OF DIRECTORS
4 BLOSSOMWOOD
FLORISSANT MO 63033-8521

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/10/2005
Organization Incorporation State MO
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: Yes
Religious: Yes
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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