FORM 1023-EZ for SHINE WITH PURPOSE
| Field | Data |
|---|---|
| EIN | 84-3231641 |
| Case Number | EO-2019345-000377 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | SHINE WITH PURPOSE |
| Organization’s Mailing Address | 6302 DEL ORO |
| City | GRANITE BAY |
| State | CA |
| ZIP | 95746 |
| Accounting period End | 6 |
| Primary contact name | MINDY MOHLENBROK |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
MINDY MOHLENBROK
PRESIDENT
6302 DEL ORO RD
GRANITE BAY CA 95746
Officer/Director/Trustee Two
MONICA NICKEL
OFFICER SPECIAL EVENTS/OUTREACH
6302 DEL ORO RD
GRANITE BAY CA 95746
Officer/Director/Trustee Three
KELLY TOMASZESKI
CHIEF DEVELOPMENT RELATIONS/VP
6302 DEL ORO RD
GRANITE BAY CA 95746
Officer/Director/Trustee Four
JESSICA WERTZ
DIRECTOR
6302 DEL ORO RD
GRANITE BAY CA 95746
Officer/Director/Trustee Five
KRISTI WASHBURN
DIRECTOR
6302 DEL ORO RD
GRANITE BAY CA 95746
| Organization’s website | N/A |
|---|---|
| Organization’s email | MINDYMOHLENBROK@SUREWEST.NET |
| Organization Incorporated | No |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 11/26/2019 |
| Organization Incorporation State | CA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | T50 - Philanthropy, Charity, Voluntarism Promotion, General |
| 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 | MINDY MOHLENBROK |
| Signature Title | PRESIDENT |
| Signature Date | 12/9/2019 |
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