FORM 1023-EZ for FOOD AND MIND INITIATIVE

Field Data
EIN 81-4948443
Case Number EO-2017013-000474
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FOOD AND MIND INITIATIVE
Organization’s Mailing Address 4505 ROCKLAND DR
City ARLINGTON
State TX
ZIP 76016-5534
Accounting period End 12
Primary contact name CESAR BALDERAS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CESAR BALDERAS
PRESIDENT
4505 ROCKLAND DR
ARLINGTON TX 76016-5534

Officer/Director/Trustee Two

ROSA BALDERAS
TREASURER
4505 ROCKLAND DR
ARLINGTON TX 76016-5534

Officer/Director/Trustee Three

JOSE BALDERAS
CHAIRPERSON
4505 ROCKLAND DR
ARLINGTON TX 76016-5534

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/10/2017
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 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 Yes
One Third Support Gifts No
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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