FORM 1023-EZ for MOUNTAIN VALLEY MENTORS

Field Data
EIN 82-4193480
Case Number EO-2018039-000237
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MOUNTAIN VALLEY MENTORS
Organization’s Mailing Address 485 1/2 RIDGE LN
City GRAND JUNCTION
State CO
ZIP 81504
Accounting period End 12
Primary contact name JOSHUA RUPPELIUS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOSHUA RUPPELIUS
PRESIDENT
485 1/2 RIDGE LN
GRAND JUNCTION CO 81504

Officer/Director/Trustee Two

CLINT SUSKEY
VICE-PRESIDENT
579 28 3/8 RD
GRAND JUNCTION CO 81504

Officer/Director/Trustee Three

STEFANIE FUOCO
TREASURER/SECRETARY
579 28 3/8 RD
GRAND JUNCTION CO 81504

Officer/Director/Trustee Four

SHAYNE HEINECKE
SUPPLY OFFICER
3268 E RD SPACE 98
CLIFTON CO 81520

Officer/Director/Trustee Five

JOSHUA TALLEY
SPORTS MANAGER
579 1/2 PLAINVIEW CT
GRAND JUNCTION CO 81504

Organization’s website
Organization’s email MOUNTAINVALLEYMENTORS@OUTLOOK.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/26/18
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N99 - Recreation, Sports, Leisure, Athletics N.E.C.
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 JOSHUA RUPPELIUS
Signature Title PRESIDENT
Signature Date 2/6/18

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