FORM 1023-EZ for ASELSI USA

Field Data
EIN 46-5696734
Case Number EO-2015082-000437
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ASELSI USA
Organization’s Mailing Address 4315 ZOE LANE
City COLUMBIA
State MO
ZIP 65201
Accounting period End 12
Primary contact name ROSE WILLIAMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SCOTT BOYD
DIRECTOR
4650 ROCK QUARRY ROAD
COLUMBIA MO 65201

Officer/Director/Trustee Two

ROSE WILLIAMS
DIRECTOR
4315 ZOE LANE
COLUMBIA MO 65201

Officer/Director/Trustee Three

BERNADETTE HERETH
DIRECTOR
550 SOUTH HWY UU
COLUMBIA MO 65203

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/22/2013
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X99 - Religion Related, Spiritual Development N.E.C.
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 Yes
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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