FORM 1023-EZ for MUSHROOM OBSERVER INC

Field Data
EIN 81-4261956
Case Number EO-2016347-000328
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MUSHROOM OBSERVER INC
Organization’s Mailing Address 68 BAY ROAD
City NORTH FALMOUTH
State MA
ZIP 02556-2404
Accounting period End 12
Primary contact name NATHAN WILSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NATHAN WILSON
PRESIDENT/DIRECTOR
68 BAY ROAD
NORTH FALMOUTH MA 02556

Officer/Director/Trustee Two

ANNE PRINGLE
VICE PRESIDENT/DIRECTOR
4 SOUTH ROBY ROAD
MADISON WI 53726-4124

Officer/Director/Trustee Three

JOHN HARPER
TREASURER/DIRECTOR
509 GREENBRIER DRIVE
SILVER SPRING MD 20910-4229

Officer/Director/Trustee Four

JOSEPH COHEN
CLERK/DIRECTOR
21082 SW MEADOW WAY
TUALATIN OR 97062-7796

Organization’s website HTTP://MUSHROOMOBSERVER.ORG
Organization’s email ADMIN@MUSHROOMOBSERVER.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/6/2016
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B99 - Education N.E.C.
Organization’s purpose Charitable: No
Religious: No
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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