FORM 1023-EZ for MISS AMY MINISTRIES

Field Data
EIN 81-2271927
Case Number EO-2016214-000497
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MISS AMY MINISTRIES
Organization’s Mailing Address 2072 SAN SEBASTIAN WAY N
City CLEARWATER
State FL
ZIP 33763
Accounting period End 12
Primary contact name TERRY FALLIS EA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

AMY MCAULEY
FOUNDER
2072 SAN SEBSTIAN WAY N
CLEARWATER FL 33758

Officer/Director/Trustee Two

GLORIA CENTONEZ
DIRECTOR
12184 111TH LANE N
LARGO FL 33778

Officer/Director/Trustee Three

TOM TOY
DIRECTOR
2370 MESSENGER CIRCLE
SAFETY HARBOR FL 34695

Organization’s website WWW.MISSAMYMINISTRIES.COM
Organization’s email MISSAMYMINISTRIES@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/29/2016
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X11 - Single Organization Support
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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 No
Unrelated Gross Income $1,000 or More Yes
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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