FORM 1023-EZ for MERCYME OUTREACH CORPORATION

Field Data
EIN 82-3558709
Case Number EO-2019064-000107
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MERCYME OUTREACH CORPORATION
Organization’s Mailing Address 6100 OHIO DR
City PLANO
State TX
ZIP 75024
Accounting period End 12
Primary contact name TMIA KELLY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TMIA KELLY
EXECUTIVE DIRECTOR
6100 OHIO DR APT 2121
PLANO TX 75024

Officer/Director/Trustee Two

LAJUAN CHAMBERS
BOARD MEMBER
3404 FM840 E
HENDERSON TX 75654

Officer/Director/Trustee Three

SHAMEISHA MYLES
BOARD MEMBER
3301 N ELM AVE APT 608
BROKEN ARROW OK 74012

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/30/17
Organization Incorporation State OK
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P42 - Single Parent Agencies, 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 TMIA KELLY
Signature Title EXECUTIVE DIRECTOR
Signature Date 3/3/19

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