FORM 1023-EZ for MISSOURI EMS MEMORIAL FOUNDATION INC

Field Data
EIN 82-3569226
Case Number EO-2018054-000181
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MISSOURI EMS MEMORIAL FOUNDATION INC
Organization’s Mailing Address 112 EAST MORRISON
City FAYETTE
State MO
ZIP 65248
Accounting period End 11
Primary contact name FRANK ROBERT FLASPOHLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GEORGE WRIGHT
CHAIRMAN
610 EAST WALNUT
SHELBINA MO 63468

Officer/Director/Trustee Two

EVAN CLARK
VICE-CHAIRMAN
208 EAST HIGHLAND AVENUE
ST JOSEPH MO 64505

Officer/Director/Trustee Three

MIKE HUESTON
TREASURER
26055 EAST REBEL ROAD
MILO MO 64767

Officer/Director/Trustee Four

DOT LAKE
SECRETARY
1367 COUNTY ROAD 133
MAYWOOD MO 63454

Officer/Director/Trustee Five

MATTHEW CUSHMAN
TRUSTEE
1922 MAIN STREET
HIGGINSVILLE MO 64037

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/27/17
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Y11 - Single Organization Support
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 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 GEORGE WRIGHT
Signature Title CHAIRMAN
Signature Date 2/21/18

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