FORM 1023-EZ for MEN OF IMPACT INC

Field Data
EIN 81-1914836
Case Number EO-2016126-000264
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MEN OF IMPACT INC
Organization’s Mailing Address PO BOX 3795
City URBANDALE
State IA
ZIP 50323-3795
Accounting period End 12
Primary contact name MARK MEYER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

GREY KYTOLA
PRESIDENT
555 SE LAUREL - 5
WEST DES MOINES IA 50263

Officer/Director/Trustee Two

GREG MCCALL
VICE PRESIDENT
3602 SW COURT
ANKENY IA 50023

Officer/Director/Trustee Three

MARK RILEY
SECRETARY
1467 POMPANO DRIVE
CLIVE IA 50325

Officer/Director/Trustee Four

MARK MEYER
TREASURER
9332 ENFIELD DRIVE
JOHNSTON IA 50131

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/22/2016
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B60 - Adult, Continuing Education
Organization’s purpose Charitable: No
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 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
Signature Title
Signature Date

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