FORM 1023-EZ for ICU MISSIONS OUTREACH INC

Field Data
EIN 86-1412202
Case Number EO-2021078-001003
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ICU MISSIONS OUTREACH INC
Organization’s Mailing Address 286 TEXAS AVE
City BRIDGEPORT
State CT
ZIP 06610
Accounting period End 12
Primary contact name MARIE BALDWIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARIE BALDWIN
PRESIDENT/CEO
286 TEXAS AVE
BRIDEPORT CT 06610

Officer/Director/Trustee Two

SHINIA DAVIS
VICE PRESIDENT
1160 STRATFORD AVENUE APT A5
STRATFORD CT 06615

Officer/Director/Trustee Three

VALARIE WASHINGTON
SECRETARY
41 GILBERT AVENUE
HAMDEN CT 06514

Officer/Director/Trustee Four

TONI BROWN
TREASURER
1180 STRATFORD AVENUE APT A5
STRATFORD CT 06615

Officer/Director/Trustee Five

ERICA BAKER
BOARD MEMBER
25 ABNER COURT
BRIDGEPORT CT 06606

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/19/2021
Organization Incorporation State CT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural Organizations - Multipurpose
Organization’s purpose Charitable: Yes
Religious: Yes
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 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 MARIE BALDWIN
Signature Title PRESIDENT/CEO
Signature Date 1/21/2021

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