FORM 1023-EZ for NSCDXVIIC DBA MASHULITUBBEE CHAPTER

Field Data
EIN 64-0704925
Case Number EO-2017275-000524
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NSCDXVIIC DBA MASHULITUBBEE CHAPTER
Organization’s Mailing Address 257 LAKEWOOD DR
City STARKVILLE
State MS
ZIP 39759-5381
Accounting period End 12
Primary contact name HELLEN POLK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

HELLEN POLK
CHAPTER PRESIDENT
650 W LAKESHORE DR
STARKVILLE MS 39759-6354

Officer/Director/Trustee Two

SANDRA FORD
CHAPTER VICE PRESIDENT
1017 COUNTY ROAD 138
NEW ALBANY MS 38652-9539

Officer/Director/Trustee Three

SUSAN LONGEST
CHAPTER RECORDING SECRETARY
4902 OLD WEST POINT ROAD
STARKVILLE MS 39759-4625

Officer/Director/Trustee Four

SARAH LAUGHLIN
CHAPTER TREASURER
257 LAKEWOOD DR
STARKVILLE MS 39759-5381

Officer/Director/Trustee Five

ELLEN MAULDIN
CHAPTER REGISTRAR
503 GREEN ST
STARKVILLE MS 39759-3315

Organization’s website
Organization’s email HELLENPOLK@FTCWEB.NET
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/10/1985
Organization Incorporation State MS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A80 - Historical Societies, Related Historical Activities
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 Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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