FORM 1023-EZ for JESUS HEALS MEDICAL OUTREACH

Field Data
EIN 47-2203990
Case Number EO-2015057-000118
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name JESUS HEALS MEDICAL OUTREACH
Organization’s Mailing Address 12915 WEINAND CIRCLE
City ROGERS
State MN
ZIP 55374
Accounting period End 12
Primary contact name AMY STUART
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

GARY MILLER
PRESIDENT
10405 TRAIL HAVEN ROAD
ROGERS MN 55374

Officer/Director/Trustee Two

CHRIS STUART
VICE PRESIDENT
4579 LASALLE AVE NE
ST MICHAEL MN 55376

Officer/Director/Trustee Three

JAN NORD
SECRETARY
12285 TUCKER ROAD
ROGERS MN 55374

Officer/Director/Trustee Four

AMY STUART
TREASURER
4579 LASALLE AVE NE
ST MICHAEL MN 55376

Organization’s website
Organization’s email INFO.JESUSHEALSMEDICAL@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/20/2014
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
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 Yes
One Third Support Gifts No
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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