FORM 1023-EZ for PAX COMMUNITY HEALTH

Field Data
EIN 84-3832548
Case Number EO-2019338-000213
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PAX COMMUNITY HEALTH
Organization’s Mailing Address 34907 E STRINGTOWN ROAD
City LONE JACK
State MO
ZIP 64070
Accounting period End 12
Primary contact name TINA PARSLEY HUGHES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LAURA VOSS
CHAIRMAN
34907 E STRINGTOWN ROAD
LONE JACK MO 64070

Officer/Director/Trustee Two

SARAH ANDERSON
VICE CHAIRMAN
202 ADMIRAL BLVD
KANSAS CITY MO 64106

Officer/Director/Trustee Three

LINDA VARGUS
SECRETARY/TREASURER
16306 HIGHT AVE
BELTON MO 64012

Officer/Director/Trustee Four

STEVE GISH
BOARD MEMBER
1103 NE BANNER
LEES SUMMIT MO 64086

Officer/Director/Trustee Five

MICHAEL MCCALL
BOARD MEMBER
1625 NW OBRIEN ROAD
LEES SUMMIT MO 64081

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/15/2019
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code M41 - First Aid Training, 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 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 LAURA VOSS
Signature Title CHAIRMAN
Signature Date 12/2/2019

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