FORM 1023-EZ for NEW MERCY MISSION HOME

Field Data
EIN 84-5038988
Case Number EO-2021099-001474
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name NEW MERCY MISSION HOME
Organization’s Mailing Address 4921 SE 73RD ST
City HAMPTON
State FL
ZIP 32044
Accounting period End 12
Primary contact name LINDSEY BORGNER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LINDSEY BORGNER
PRESIDENT
4921 SE 73RD ST
HAMPTON FL 32044

Officer/Director/Trustee Two

TERRI ROSIER
VICE-PRESIDENT
21057 NW 82ND LN
STARKE FL 32091

Officer/Director/Trustee Three

LINDA BENNETT
SECRETARY
17322 MELVIN ST
BROOKER FL 32622

Organization’s website
Organization’s email NEWMERCYMISSIONHOME@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/14/2020
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L41 - Homeless, Temporary Shelter For
Organization’s purpose Charitable: Yes
Religious: Yes
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 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 TERRI ROSIER
Signature Title VICE-PRESIDENT
Signature Date 3/19/2021

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