FORM 1023-EZ for MOMENTS OF MERCY

Field Data
EIN 84-3400306
Case Number EO-2020244-000681
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MOMENTS OF MERCY
Organization’s Mailing Address 853 S WALNUT AVE
City COOKEVILLE
State TN
ZIP 38501
Accounting period End 12
Primary contact name MISTY PHY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MISTY PHY
PRESIDENT
853 S WALNUT AVE
COOKEVILLE TN 38501

Officer/Director/Trustee Two

ASHLEY ALLEN
TREASURER
652 MAXWELL ST
COOKEVILLE TN 38501

Officer/Director/Trustee Three

NATHAN PAYNE
SECRETARY
25 W BROAD ST STE 9
COOKEVILLE TN 38501

Officer/Director/Trustee Four

BILL GIBSON
DIRECTOR
25 W BROAD ST STE 9
COOKEVILLE TN 38501

Officer/Director/Trustee Five

RON PHILLIPS
DIRECTOR
875 S WALNUT AVE
COOKEVILLE TN 38501

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/27/2020
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P40 - Family 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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name MISTY PHY
Signature Title PRESIDENT
Signature Date 8/28/2020

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