FORM 1023-EZ for FRIENDS OF A SAFE PLACE

Field Data
EIN 81-2612660
Case Number EO-2016214-000288
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FRIENDS OF A SAFE PLACE
Organization’s Mailing Address 227 E MAIN STREET
City FESTUS
State MO
ZIP 63028
Accounting period End 5
Primary contact name MEAGAN BREEZE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARK MERTENS
CHAIRPERSON
701 PENNY LANE
IMPERIAL MO 63052

Officer/Director/Trustee Two

JERRY ROGERS
VICE-CHAIRPERSON
3671 S LAKESHORE
HOUSE SPRINGS MO 63051

Officer/Director/Trustee Three

KATHRYN ELLIS
SECRETARY
208 BARRINGTON PLACE
FESTUS MO 63028

Officer/Director/Trustee Four

ANN PORTELL
TREASURER
5921 STATE ROAD H
DE SOTO MO 63020

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/19/2016
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P43 - Family Violence Shelters, Services
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 No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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