FORM 1023-EZ for MOTHERS COTTAGE INC

Field Data
EIN 81-4579007
Case Number EO-2016351-000326
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MOTHERS COTTAGE INC
Organization’s Mailing Address 13331 SE 160TH TERRACE
City ARCHER
State FL
ZIP 32168
Accounting period End 12
Primary contact name MAXWELL MINCH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHELLE HARRIS
DIRECTOR
13331 SW 160TH TERRACE
ARCHER FL 32168

Officer/Director/Trustee Two

KIPPER LYNN BEARCROWE POORE
DIRECTOR
13331 SW 160TH TERRACE
ARCHER FL 32168

Officer/Director/Trustee Three

CATHY ALLISON-STUBEE
DIRECTOR
13621 SW 4TH LANE
NEWBERRY FL 32669

Officer/Director/Trustee Four

MAXWELL MINCH
DIRECTOR
720 SW 2ND AVE SUITE 106
GAINESVILLE FL 32601

Organization’s website N/A
Organization’s email MOTHERSCOTTAGE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/2/2016
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P30 - Children's, Youth Services
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 No
Gaming Activity No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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