FORM 1023-EZ for MEDICAL MISSION INTERNATIONAL

Field Data
EIN 81-4904612
Case Number EO-2017104-000149
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MEDICAL MISSION INTERNATIONAL
Organization’s Mailing Address PO BOX 190
City ROLLINSFORD
State NH
ZIP 03869
Accounting period End 12
Primary contact name LEANNE PELLERIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PASTOR ERIC PHINNEY
PRESIDENT
PO BOX 190
ROLLINSFORD NH 03869

Officer/Director/Trustee Two

SHANTA DAWSON
SECRETARY/TREASURER
PO BOX 190
ROLLINSFORD NH 03869

Officer/Director/Trustee Three

LEANNE PELLERIN
DIRECTOR
PO BOX 190
ROLLINSFORD NH 03869

Officer/Director/Trustee Four

MADELEINE ALLARD
DIRECTOR
PO BOX 190
ROLLINSFORD NH 03869

Officer/Director/Trustee Five

CHANTALE CARPENTER
DIRECTOR
PO BOX 190
ROLLINSFORD NH 03869

Organization’s website WWW.MEDICALMISSION.CA
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/27/2017
Organization Incorporation State NH
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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