FORM 1023-EZ for MEET MY SHOES

Field Data
EIN 47-2132587
Case Number EO-2016312-000305
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MEET MY SHOES
Organization’s Mailing Address 4115 DORSET DRIVE
City ROCKFORD
State IL
ZIP 61114
Accounting period End 12
Primary contact name FLORETTA LEAVY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

FLORETTA LEAVY
PRESIDENT
4115 DORSET DRIVE
ROCKFORD IL 61114

Officer/Director/Trustee Two

AARON PERRYMOND
DIRECTOR
103 VERSAILLES CT
MAUMELLE AR 72113

Officer/Director/Trustee Three

PIERRE ADAMS
DIRECTOR
1401 STONEY CREEK WAY
ROCKFORD IL 61108

Officer/Director/Trustee Four

STAVHN LEAVY
DIRECTOR
1401 STONEY CREEK WAY
ROCKFORD IL 61108

Officer/Director/Trustee Five

DOUGLAS LEAVY
DIRECTOR
4115 DORSET DRIVE
ROCKFORD IL 61114

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/1/2015
Organization Incorporation State IL
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: Yes
Scientific: No
Literary: Yes
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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