FORM 1023-EZ for HELMETS 4 KIDS

Field Data
EIN 30-0713412
Case Number EO-2016036-000223
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HELMETS 4 KIDS
Organization’s Mailing Address PO BOX 145
City VALLEY SPRINGS
State SD
ZIP 57068
Accounting period End 12
Primary contact name MELISSA HENDRICKS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MELISSA HENDRICKS
VICE PRESIDENT
305 JACKSON STREET
VALLEY SPRINGS SD

Officer/Director/Trustee Two

TROY MUNDT
PRESIDENT
4401 E RONNING DRIVE APT 1
SIOUX FALLS SD

Officer/Director/Trustee Three

DEBORAH COOPERRIDER
DIRECTOR
4401 E RONNING DRIVE APT 1
SIOUX FALLS SD 57103

Organization’s website WWW.HELMETS4KIDS.ORG
Organization’s email HELMETS4KIDS@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/7/2012
Organization Incorporation State SD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W01 - Alliance/Advocacy Organizations
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 Yes
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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