FORM 1023-EZ for BELIZE MISSION SOCIETY FORO

Field Data
EIN 81-3540004
Case Number EO-2019240-000189
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BELIZE MISSION SOCIETY FORO
Organization’s Mailing Address 4015 CASCADE SKY DR
City ARLINGTON
State TX
ZIP 76005
Accounting period End 12
Primary contact name SUSAN DORN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SUSAN DORN
EXECUTIVE DIRECTOR
401
ARLINGTON TX 76005

Officer/Director/Trustee Two

CATHY DULGAR
DIRECTOR
2822 KARR ROAD
BELIVIDERE IL 61008

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/12/16
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X21 - Protestant
Organization’s purpose Charitable: No
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name SUSAN DORN
Signature Title EXECUTIVE DIRECTOR
Signature Date 8/26/19
EIN 81-3540004
Case Number EO-2016229-000389
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BELIZE MISSION SOCIETY FORO
Organization’s Mailing Address 1501 LACK RIDGE DR
City WILDWOOD
State MO
ZIP 63021
Accounting period End 12
Primary contact name DAVE BERGMANN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SUE DORN
PRESIDENT
5004 DEERWOOD PARK DR
ARLINGTON TX 76017

Officer/Director/Trustee Two

DAVE BERGMANN
CHAIRMAN
1501 LACK RIDGE DR
WILDWOOD MO 63021

Officer/Director/Trustee Three

BRENDA FINLEY
TREASURER
553 WYATT DR
SAINT PETERS MO 63376

Officer/Director/Trustee Four

CATHY DULGAR
SECRETARY
2822 KARR RD
BELVIDERE IL 61008

Organization’s website
Organization’s email SUEDORN6@AOL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/12/2016
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
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 Yes
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
Signature Title
Signature Date

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