FORM 1023-EZ for MIXED ROOTS STORIES

Field Data
EIN 46-3876630
Case Number EO-2016278-000380
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MIXED ROOTS STORIES
Organization’s Mailing Address 1049 HAVENHURST UNIT 183
City WEST HOLLYWOOD
State CA
ZIP 90046-6002
Accounting period End 12
Primary contact name MARK R EDWARDS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHANDRA CRUDUP
PRESIDENT
1049 HAVENHURST UNIT 183
WEST HOLLYWOOD CA 90046-6002

Officer/Director/Trustee Two

KAILY HEITZ
SECRETARY
1049 HAVENHURST UNIT 183
WEST HOLLYWOOD CA 90046-6002

Officer/Director/Trustee Three

FANSHEN COX DIGIOVANNI
DIRECTOR
1049 HAVENHURST UNIT 183
WEST HOLLYWOOD CA 90046-6002

Officer/Director/Trustee Four

MARK R EDWARDS
TREASURER
1049 HAVENHURST UNIT 183
WEST HOLLYWOOD CA 90046-6002

Organization’s website WWW.MIXEDROOTSSTORIES.ORG
Organization’s email INFO@MIXEDROOTSSTORIES.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/23/2013
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A23 - Cultural, Ethnic Awareness
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 Yes
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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