FORM 1023-EZ for MPACT MENS MINISTRIES INC

Field Data
EIN 85-0819499
Case Number EO-2020218-000244
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MPACT MENS MINISTRIES INC
Organization’s Mailing Address 4450 PORTAGE TRAIL
City MELBOURNE
State FL
ZIP 32940
Accounting period End 12
Primary contact name TREY ETHERIDGE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

HERBERT K ETHERIDGE
PRESIDENT FOUNDER
4450 PORTAGE TRAIL
MELBOURNE FL 32940

Officer/Director/Trustee Two

DONNA ETHERIDGE
VP
4450 PORTAGE TRAIL
MELBOURNE FL 32940

Officer/Director/Trustee Three

HERBERT ETHERIDGE
DIRECTOR
3852 CARAMBOLA
MELBOURNE FL 32940

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/17/2020
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: Yes
Religious: Yes
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 Yes
Donation of funds Yes
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 HERBERT K ETHERIDGE
Signature Title PRESIDENT FOUNDER
Signature Date 8/3/2020

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