FORM 1023-EZ for MOTIVATIONAL INTERVIEWING IN LEADERSHIP AND ORGANIZATIONS

Field Data
EIN 87-1384064
Case Number EO-2021179-000519
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MOTIVATIONAL INTERVIEWING IN LEADERSHIP AND ORGANIZATIONS
Organization’s Mailing Address 50 CARMEL CT
City ROSEBURG
State OR
ZIP 97471
Accounting period End 12
Primary contact name JASON WILCOX
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

COLLEEN MARSHALL
PRESIDENT
778 OAK HOLLOW RD
CRYSTAL LAKE IL 60014

Officer/Director/Trustee Two

GREG SUMPTER
TREASURE
2528 ROYAL LN
DENTON TX 76209

Officer/Director/Trustee Three

ELIZABETH JENKINS
SECRETARY
1101 E PATTERSON ST
TAMPA FL 33604

Officer/Director/Trustee Four

JASON WILCOX
BOARD MEMBER
50 CARMEL CT
ROSEBURG OR 97471

Organization’s website WWW.MIINLEADERSHIPANDORGANIZATIONS.COM
Organization’s email JASON.H.WILCOX@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/24/2021
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Z99 - Unclassified
Organization’s purpose Charitable: No
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 JASON WILCOX
Signature Title BOARD MEMBER
Signature Date 6/25/2021

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