FORM 1023-EZ for JIREH INDIA MISSIONS NFP

Field Data
EIN 36-4786825
Case Number EO-2014265-000228
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name JIREH INDIA MISSIONS NFP
Organization’s Mailing Address 2211 RACCOON LANE
City CENTRALIA
State IL
ZIP 62801
Accounting period End 12
Primary contact name JEFFREY DAHLQUIST
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LANCE MARCUM
PRESIDENT
539 NANCY DR
CENTRALIA IL 62801

Officer/Director/Trustee Two

SCOTT BALLAH
SECRETARY
1022 WOODS WAY
O'FALLON IL 62269

Officer/Director/Trustee Three

JEFFREY DAHLQUIST
TREASURER
2211 RACCOON LN
CENTRALIA IL 62801

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/23/2013
Organization Incorporation State IL
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: 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 Yes
Conducting Activities Outside of United States Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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