FORM 1023-EZ for FORT WORTH MUSIC THERAPY FUND

Field Data
EIN 84-2129831
Case Number EO-2019340-000154
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FORT WORTH MUSIC THERAPY FUND
Organization’s Mailing Address P O BOX 33913
City FORT WORTH
State TX
ZIP 76162
Accounting period End 12
Primary contact name NIKKI BELSHE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

HEATHER BELSHE
PRESIDENT
8017 MOSS ROCK DR
FORT WORTH TX 76123

Officer/Director/Trustee Two

WILLIAM HAYTER
VICE PRESIDENT
P O BOX 33931
FORT WORTH TX 76162

Officer/Director/Trustee Three

LORI ARCHIBALD
SECRETARY
8021 MOSS ROCK DR
FORT WORTH TX 76123

Officer/Director/Trustee Four

ELLIE SLOAN
TREASURER
P O BOX 33913
FORT WORTH TX 76162

Officer/Director/Trustee Five

PAM MITCHEL
BOARD MEMBER
601 PARADISE COVE
SHADY SHORES TX 76208

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/18/2019
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A68 - Music
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 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 HEATHER BELSHE
Signature Title PRESIDENT
Signature Date 12/4/2019

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