FORM 1023-EZ for MOTHERLAND CONCEPTS INC

Field Data
EIN 81-0812687
Case Number EO-2019098-000295
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MOTHERLAND CONCEPTS INC
Organization’s Mailing Address 111 HUNTINGTON ROAD
City WORTHINGTON
State MA
ZIP 1098-9507
Accounting period End 12
Primary contact name DIANA NOBLE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DIANA NOBLE
PRESIDENT/DIRECTOR
890 MAIN STREET
DALTON MA 1226-2216

Officer/Director/Trustee Two

DAVID DERY
TREASURER/DIRECTOR
138 HUTCHINSON LANE
CHESHIRE MA 1225-9723

Officer/Director/Trustee Three

SUSAN WALKO
TRUSTEE
3 OXYOKE DRIVE
METHUEN MA 1844-1854

Organization’s website
Organization’s email MLCINFINFO@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/30/15
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code C50 - Environmental Beautification and Aesthetics
Organization’s purpose Charitable: Yes
Religious: No
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 Yes
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 Yes
Correctness Declaration Yes
Signature Name DIANA NOBLE
Signature Title PRESIDENT/DIRECTOR
Signature Date 4/5/19

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