FORM 1023-EZ for THE MONARCH MIDWIFE

Field Data
EIN 47-4385883
Case Number EO-2015187-000487
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE MONARCH MIDWIFE
Organization’s Mailing Address 500 CROSS MOUNTAIN DRIVE
City FREDERICKSBURG
State TX
ZIP 78624
Accounting period End 12
Primary contact name KIMBERLY SMAJSTRLA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KIMBERLY SMAJSTRLA
PRESIDENT
500 CROSS MOUNTAIN DRIVE
FREDERICKSBURG TX 78624

Officer/Director/Trustee Two

SUSAN AWALT
VICE PRESIDENT
1909 LOHMAN FORD ROAD
LAGO VISTA TX 78645

Officer/Director/Trustee Three

PATRICK MOORE
TREASURER
150 EAST MAIN STREET SUITE 206
FREDERICKSBURG TX 78624

Officer/Director/Trustee Four

DEBBI MCCURDY
SECRETARY
404 NORTH LLANO
FREDERICKSBURG TX 78624

Organization’s website WWW.THEMONARCHMIDWIFE.ORG
Organization’s email THEMONARCHMIDWIFE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/2/2015
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D30 - Wildlife Preservation, Protection
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 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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