FORM 1023-EZ for BACKROADS 4-H

Field Data
EIN 46-1121812
Case Number EO-2020100-000176
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BACKROADS 4-H
Organization’s Mailing Address 8510 S 1150 ROAD
City RICHARDS
State MO
ZIP 64778
Accounting period End 12
Primary contact name LORI CHADD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RANAE LUTHER
PRESIDENT
8510 S 1150 ROAD
RICHARDS MO 64778

Officer/Director/Trustee Two

LORI CHADD
SECRETARY
19553 E NOAH ROAD
NEVADA MO 64772

Officer/Director/Trustee Three

AMANDA ERWIN
TREASURER
18500 S 1600 ROAD
NEVADA MO 64772

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/30/2020
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: No
Religious: No
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name RANAE LUTHER
Signature Title PRESIDENT
Signature Date 4/7/2020

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