FORM 1023-EZ for MIA MAC FOUNDATION

Field Data
EIN 82-4203604
Case Number EO-2018038-000077
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MIA MAC FOUNDATION
Organization’s Mailing Address 131 COUNTY RD 289
City PACHUTA
State MS
ZIP 39347
Accounting period End 12
Primary contact name TONYA BROOKS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TONYA BROOKS
PRESIDENT
5814 FIRETHORNE DR
HOLLAND OH 43615

Officer/Director/Trustee Two

ALFONZO MCDYESS
VICE PRESIDENT
979 COUNTY RD 473
MERIDIAN MS 39301

Officer/Director/Trustee Three

LONI JOHNSON
SECRETARY
159 COUNTY RD 289
PACHUTA MS 39347

Officer/Director/Trustee Four

VICTORIA JOHNSON
TREASURER
803 29TH STREET APT 324
MERIDIAN MS 39305

Officer/Director/Trustee Five

CORDARIYON MCDYESS
TRUSTEE
5963 WALNUT CIRCLE
TOLEDO OH 43615

Organization’s website
Organization’s email MIAMACFOUNDATION@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/1/17
Organization Incorporation State MS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 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 TONYA BROOKS
Signature Title PRESIDENT
Signature Date 2/3/18

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