FORM 1023-EZ for PHOTHISOMPHAN MEDITATION MONSTERY

Field Data
EIN 45-4201564
Case Number EO-2015091-000240
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PHOTHISOMPHAN MEDITATION MONSTERY
Organization’s Mailing Address 2562 SE 14TH STREET
City DES MOINES
State IA
ZIP 50320
Accounting period End 12
Primary contact name YING SA CPA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SOMPHAN SINGVILAY
PRESIDENT
2562 SE 14TH ST
DES MOINES IA 50320

Officer/Director/Trustee Two

KHAMVANH KANLAGNA
VICE PRESIDENT
715 37TH ST
DES MOINES IA 50312

Officer/Director/Trustee Three

THANET PLATHONG
VICE PRESIDENT
416 SUNRISE PARK
PELLA IA 50219

Officer/Director/Trustee Four

PHONEXAY VILAVONGSA
SECRETARY
1818 YORK ST
DES MOINES IA 50316

Officer/Director/Trustee Five

PHENSY SAYAVONGCHANH
TREASURER
1031 65TH ST
WINDSOR HEIGHS IA 50324

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/28/2011
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X50 - Buddhist
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 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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