FORM 1023-EZ for DR ROY MOSS FOUNDATION INC

Field Data
EIN 83-3225033
Case Number EO-2019051-000329
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DR ROY MOSS FOUNDATION INC
Organization’s Mailing Address 14020 CEDAR ST
City OVERLAND PARK
State KS
ZIP 66224
Accounting period End 12
Primary contact name DAVID MOSS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID MOSS
PRESIDENT/TREASURER/DIRECTOR
14020 CEDAR ST
OVERLAND PARK KS 66224

Officer/Director/Trustee Two

PATRICIA MOSS
SECRETARY/DIRECTOR
13300 PENNSYLVANIA CT
KANSAS CITY MO 64145

Officer/Director/Trustee Three

BRYSON MOSS
VICE PRESIDENT/DIRECTOR
875 KENSINGTON COVE
SPRINGDALE AR 72762

Officer/Director/Trustee Four

PATRICK MOSS
DIRECTOR
5406 W 140TH ST
OVERLAND PARK KS 66224

Officer/Director/Trustee Five

MICHAEL MOSS
DIRECTOR
7144 SPRINGFIELD ST
PRAIRIE VILLAGE, KS 66208

Organization’s website WWW.ROYMOSSFOUNDATION.ORG/
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/25/18
Organization Incorporation State KS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T99 - Philanthropy, Voluntarism, and Grantmaking Foundations 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 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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name DAVID MOSS
Signature Title PRESIDENT/TREASURER/DIRECTOR
Signature Date 2/15/19

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