FORM 1023-EZ for DOWN SYNDROME ASSOCIATION OF NORTHCENTRAL IOWA

Field Data
EIN 38-3916660
Case Number EO-2014328-000273
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DOWN SYNDROME ASSOCIATION OF NORTHCENTRAL IOWA
Organization’s Mailing Address PO BOX 4
City MASON CITY
State IA
ZIP 50401-6919
Accounting period End 12
Primary contact name ANN BAILEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ANN BAILEY
TREASURER
7326 210TH STREET
CLEAR LAKE IA 50428-2350

Officer/Director/Trustee Two

JOSETTE DUNCAN
PRESIDENT
735 W 5TH
GARNER IA 50438-0001

Officer/Director/Trustee Three

NANCY QUADE
VICE PRESIDENT/SECRETARY
11244 PARTRIDGE AVENUE
MASON CITY IA 50401-6919

Officer/Director/Trustee Four

TENISHA BENSON
AT-LARGE BOARD MEMBER
7 NELSON STREET
VENTURA IA 50482-5000

Officer/Director/Trustee Five

LORRA STILES
AT-LARGE MEMBER
21 NORTH SULLIVAN AVENUE
NORA SPRINGS IA 50458-0001

Organization’s website WWW.DSA-NCI.COM
Organization’s email DSANORTHCENTRALIOWA@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/22/2014
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G25 - Down Syndrome
Organization’s purpose Charitable: Yes
Religious: Yes
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 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
Signature Title
Signature Date

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