FORM 1023-EZ for MISSOURI ASSOCIATION FOR INFANT ANDEARLY CHILDHOOD MENTAL HEALTH

Field Data
EIN 81-2206934
Case Number EO-2016155-000258
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MISSOURI ASSOCIATION FOR INFANT ANDEARLY CHILDHOOD MENTAL HEALTH
Organization’s Mailing Address PO BOX 45835
City KANSAS CITY
State MO
ZIP 64171
Accounting period End 12
Primary contact name PATTY DAVIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

PATRICIA DAVIS
PRESIDENT
DEPT OF SW/ 2401 GILLHAM RD
KANSAS CITY MO 64108

Officer/Director/Trustee Two

GLADESIA TOLBERT
TREASURER
3039 TROOST AVE
KANSAS CITY MO 64109

Officer/Director/Trustee Three

LISA POLKA
SECRETARY
DEPT OF SW/ 2401 GILLHAM RD
KANSAS CITY MO 64108

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/2/2016
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E01 - Alliance/Advocacy Organizations
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 No
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
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
Signature Title
Signature Date

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