FORM 1023-EZ for KICKING FOR MIRACLES TRIAD

Field Data
EIN 84-3762713
Case Number EO-2019331-000251
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KICKING FOR MIRACLES TRIAD
Organization’s Mailing Address 1425 RIVER RIDGE DRIVE
City CLEMMONS
State NC
ZIP 27012
Accounting period End 12
Primary contact name KRISTIN MASALLERAS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KRISTIN MASALLERAS
SECRETARY
6020 CRESCENTBROOK LANE
CLEMMONS NC 27012

Organization’s website
Organization’s email TIGERKIMSKFM@OUTLOOK.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/21/19
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T12 - Fund Raising and/or Fund Distribution
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 KRISTIN MASALLERAS
Signature Title SECRETARY
Signature Date 11/25/19

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