FORM 1023-EZ for THE MASTECTOMY BOUTIQUE

Field Data
EIN 83-2216576
Case Number EO-2018291-000130
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE MASTECTOMY BOUTIQUE
Organization’s Mailing Address 4700 WICHERS DR SUITE 201
City MARRERO
State LA
ZIP 70072
Accounting period End 12
Primary contact name IISHA K BAILEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

IISHA BAILEY
CHIEF EXECUTIVE OFFICER
3121 TYLA CT
HARVEY LA 70058

Officer/Director/Trustee Two

FRANK BAILEY
EXECUTIVE DIRECTOR
4700 WICHERS DR STE 201
MARRERO LA 70072

Organization’s website WWW.THEMASTECTOMYBOUTIQUE.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/16/18
Organization Incorporation State LA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G32 - Breast Cancer
Organization’s purpose Charitable: Yes
Religious: Yes
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 Yes
Donation of funds Yes
Conducting Activities Outside of United States Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name IISHA BAILEY
Signature Title CHIEF EXECUTIVE OFFICER
Signature Date 10/16/18

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