FORM 1023-EZ for MT MORIAH COMMUNITY MINISTRY INC

Field Data
EIN 71-0759293
Case Number EO-2015306-000243
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MT MORIAH COMMUNITY MINISTRY INC
Organization’s Mailing Address 920 LAKE STREET
City BLYTHEVILLE
State AR
ZIP 72315
Accounting period End 12
Primary contact name PATRICK TAFT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

THEODIS RUCKER
PRESIDENT
111 SOUTH GOSNELL
GOSNELL AR 72315

Officer/Director/Trustee Two

JAMES BROWN
VICE PRESIDENT
300 SOUTH LAKE
BLYTHEVILLE AR 72315

Officer/Director/Trustee Three

LORENE SMITH
SECRETARY
1116 LEAWOOD
BLYTHEVILLE AR 72315

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/11/1994
Organization Incorporation State AR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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