FORM 1023-EZ for MIDLAND MIDDLE SCHOOL PTO

Field Data
EIN 82-3063190
Case Number EO-2017292-000368
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MIDLAND MIDDLE SCHOOL PTO
Organization’s Mailing Address 901 HILLTOP DRIVE
City SPARLAND
State IL
ZIP 61565
Accounting period End 6
Primary contact name MELISSA BADE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ADAM JANSSEN
PRESIDENT
412 OLIVE STREET
VARNA IL 61375

Officer/Director/Trustee Two

MELISSA BADE
VICE PRESIDENT
837 COUNTY ROAD 1625E
LACON IL 61540

Officer/Director/Trustee Three

JESSICA LARUE
SECRETARY
417 SOUTH PRARIE STREET
LACON IL 61540

Officer/Director/Trustee Four

DENISE BALENSIEFEN
TREASURER
1108 NORTH PRARIE STREET
LACON IL 61540

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/1/2017
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B94 - Parent/Teacher Group
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
Signature Title
Signature Date

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