FORM 1023-EZ for MELISSA PAYS IT FORWARD

Field Data
EIN 87-1736081
Case Number EO-2021274-000041
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MELISSA PAYS IT FORWARD
Organization’s Mailing Address 1919 E MELISSA ROAD PO BOX 491
City MELISSA
State TX
ZIP 75454
Accounting period End 11
Primary contact name KACIE BAXLEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KACIE BAXLEY
EXECUTIVE DIRECTOR
1919 E MELISSA ROAD
MELISSA TX 75454

Officer/Director/Trustee Two

SHANNON SWEAT
PRESIDENT
POBOX 21
MELISSA TX 75454

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/19/2021
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P40 - Family Services
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 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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name KACIE BAXLEY
Signature Title EXECUTIVE DIRECTOR
Signature Date 9/29/2021

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