FORM 1023-EZ for MERCY WAY ALLIANCE INC

Field Data
EIN 84-2076464
Case Number EO-2019210-000418
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MERCY WAY ALLIANCE INC
Organization’s Mailing Address 5800 BEACH BLVD STE 111
City JACKSONVILLE
State FL
ZIP 32207
Accounting period End 12
Primary contact name KRISTA SMITH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KRISTA SMITH
PRESIDENT
STE 111
JACKSONVILLE FL 32207

Officer/Director/Trustee Two

JACOB SMITH
TRESURER
5800 BEACH BLVD STE 111
JACKSONVILLE FL 32207

Officer/Director/Trustee Three

PATRICIA MARQUEZ
SECRETARY
5800 BEACH BLVD STE 111
JACKSONVILLE FL 32207

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/3/19
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other 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 Yes
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
Gaming Activity No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name PATRICIA MARQUEZ
Signature Title SECRETARY
Signature Date 7/26/19

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