FORM 1023-EZ for MOMMY ME HEALTHY START COMMUNITY OUTREACH PROJECT

Field Data
EIN 47-1593921
Case Number EO-2014230-000224
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MOMMY ME HEALTHY START COMMUNITY OUTREACH PROJECT
Organization’s Mailing Address PO BOX 2042
City STOCKTON
State CA
ZIP 95201-2042
Accounting period End 12
Primary contact name DALINE MAGEE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

YVETTE SHIELDS
CHAIR
10413 CARNEGIE CT
STOCKTON CA 95209

Officer/Director/Trustee Two

DALINE MAGEE
VICE-CHAIR
1607 PORTER WAY
STOCKTON CA 95207

Officer/Director/Trustee Three

TONIA MADERE
SECRETARY
4030 MCDOUGALD BLVD
STOCKTON CA 95206

Officer/Director/Trustee Four

INGRID GLENN
TREASURY
4777 GROUSE RUNN APT 236
STOCKTON CA 95207

Officer/Director/Trustee Five

COLETTE GRAVES
MEMBER
3632 S MERRIMAC CIRCLE
STOCKTON CA 95219

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/31/2014
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E60 - Health Support Services
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 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
Signature Title
Signature Date

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