FORM 1023-EZ for MEDICINE WITH A MISSION INC

Field Data
EIN 81-4055834
Case Number EO-2016285-000514
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MEDICINE WITH A MISSION INC
Organization’s Mailing Address 624 TALON COURT
City ARNOLD
State MD
ZIP 21012-2822
Accounting period End 12
Primary contact name EUGENE F DEEMS JR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOSHUA CARLSON
DIRECTOR
29728 DUSTIN AVENUE
EASTON MD 21601

Officer/Director/Trustee Two

MARGO COOK
DIRECTOR
118 BAVARIAN TURN
CENTREVILLE MD 21617

Officer/Director/Trustee Three

EUGENE DEEMS JR
DIRECTOR
624 TALON COURT
ARNOLD MD 21012-2822

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/24/2016
Organization Incorporation State MD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E60 - Health Support Services
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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 Yes
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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