FORM 1023-EZ for MISSION TEAM IMPACT

Field Data
EIN 47-2309501
Case Number EO-2014342-000275
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MISSION TEAM IMPACT
Organization’s Mailing Address 4810 SOUTH ARBUTUS STREET
City MORRISON
State CO
ZIP 80465
Accounting period End 7
Primary contact name TILO LOPEZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TILO LOPEZ
PRESIDENT
4810 SOUTH ARBUTUS STREET
MORRISON CO 80465

Officer/Director/Trustee Two

GINA LOPEZ
VICE PRESIDENT
4810 SOUTH ARBUTUS STREET
MORRISON CO 80465

Officer/Director/Trustee Three

ATHENA ARROYO
TREASUER
8901 QUIGLEY STREET
WESTMINSTER CO 80031

Officer/Director/Trustee Four

MICHELLE ARCHULETTA
SECRETARY
1859 SOUTH REED COURT
LAKEWOOD CO 80232

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/12/2014
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S01 - Alliance/Advocacy Organizations
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 Yes
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
Gaming Activity No
Disaster relief assistance Yes
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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