FORM 1023-EZ for M O M MOTHERS ON A MISSION

Field Data
EIN 47-1732643
Case Number EO-2016055-000120
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name M O M MOTHERS ON A MISSION
Organization’s Mailing Address PO BOX 292481
City COLUMBIA
State SC
ZIP 29229-7742
Accounting period End 8
Primary contact name JERICHA PETERSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JERICHA PETERSON
CHIEF EXECUTIVE OFFICER /FOUNDER
9 LONG GLEN COURT
COLUMBIA SC 29229-7742

Officer/Director/Trustee Two

SHERICA WARFIELD
CHIEF FINANCIAL OFFICER/CO-FOUNDER
412 SAURUS COURT
FLORENCE SC 29505

Officer/Director/Trustee Three

MARCHIETA COCKFIELD
CHIEF MARKETING OFFICER
1044 BUTTERCUP CIRCLE
COLUMBIA SC 29016

Officer/Director/Trustee Four

ROBIN MIDDLETON
CHIEF OPERATIONS OFFICER
PO BOX 83
WADMALAW ISLAND SC 29487

Organization’s website WWW.MOTHERSONAMISSION1.WIX.COM/MOTHERSONAMISSION1
Organization’s email MOTHERSONAMISSION1@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/5/2014
Organization Incorporation State SC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: Yes
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 Yes
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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