FORM 1023-EZ for MUDRUN4LIFE

Field Data
EIN 84-2469324
Case Number EO-2019210-000398
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MUDRUN4LIFE
Organization’s Mailing Address 550 NELSON LN
City LINCOLN
State CA
ZIP 95648
Accounting period End 12
Primary contact name KELLY WATERLYN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KELLY WATERLYN
PRESIDENT, DIRECTOR
550 NELSON LN
LINCOLN CA 95648

Officer/Director/Trustee Two

ROSA AGUILAR
SECRETARY, DIRECTOR
550 NELSON LN
LINCOLN CA 95648

Officer/Director/Trustee Three

TINA WHALEN
TREASURER, DIRECTOR
550 NELSON LN
LINCOLN CA 95648

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/10/19
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
Organization’s purpose Charitable: Yes
Religious: No
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 No
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 KELLY WATERLYN
Signature Title PRESIDENT, DIRECTOR
Signature Date 7/26/19

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