FORM 1023-EZ for MS MOMENTS

Field Data
EIN 47-3773044
Case Number EO-2015120-000314
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MS MOMENTS
Organization’s Mailing Address 7118 HORTON AVE
City URBANDALE
State IA
ZIP 50322
Accounting period End 12
Primary contact name CHRIS KLOCKE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CHRIS KLOCKE
CHAIR
7118 HORTON AVE
URBANDALE IA 50322

Officer/Director/Trustee Two

KARRIE ANDERSEN
CO-CHAIR
411 SW KENNYBROOK DR
GRIMES IA 50111

Officer/Director/Trustee Three

CRIS ANDERSEN
TREASURER
411 SW KENNYBROOK DR
GRIMES IA 50111

Officer/Director/Trustee Four

DAVE BAKER
EVENT COORDINATOR
209 EWING COURT
GRIMES IA 50111

Officer/Director/Trustee Five

DENISE BORING
MARKETING COMMUNICATIONS
4653 84TH ST
URBANDALE IA 50322-1090

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/11/2015
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T12 - Fund Raising and/or Fund Distribution
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
Signature Title
Signature Date

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