FORM 1023-EZ for MOUNTAIN GROVE LIONS FOUNDATION

Field Data
EIN 80-0545064
Case Number EO-2014310-000486
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MOUNTAIN GROVE LIONS FOUNDATION
Organization’s Mailing Address PO BOX 348
City MOUNTAIN GROVE
State MO
ZIP 65711-0348
Accounting period End 6
Primary contact name JAMES RAY RICHEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JAMES RAY RICHEY
PRESIDENT
PO BOX 348
MOUNTAIN GROVE MO 65711-0348

Officer/Director/Trustee Two

THOMAS JOHNS
VICE-PRESIDENT
1725 CLOUSE RD
MACOMB MO 65702

Officer/Director/Trustee Three

SANDRA RICHEY
SECRETARY
PO BOX 348
MOUNTAIN GROVE MO 65711-0348

Officer/Director/Trustee Four

DARRELL KOCHIS
TREASURER
3246 SPARKS RD
NORWOOD MO 65717

Officer/Director/Trustee Five

VICKI THOMPSON
DIRECTOR
6620 EAST OUTER RD
NORWOOD MO 65717

Organization’s website WWW.FACEBOOK.COM/MGLIONSCLUB
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/21/2014
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S80 - Community Service Clubs
Organization’s purpose Charitable: Yes
Religious: No
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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