FORM 1023-EZ for MARK HARRISON CANCER FOUNDATION

Field Data
EIN 81-1706026
Case Number EO-2017074-000148
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MARK HARRISON CANCER FOUNDATION
Organization’s Mailing Address 6377 31ST AVENUE
City SHELLSBURG
State IA
ZIP 52332
Accounting period End 3
Primary contact name DEB HARRISON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DEB HARRISON
PRESIDENT TREASURER
6377 31ST AVENUE
SHELLSBURG IA 52332

Officer/Director/Trustee Two

MITCHELL HARRISON
BOARD MEMBER
1019 POPLAR
LA PORTE CITY IA 50651

Officer/Director/Trustee Three

GORDON HARRISON
BOARD MEMBER
102 JOHNSON STREET SW
SHELLSBURG IA 52332

Officer/Director/Trustee Four

MIKE HARRISON
BOARD MEMBER
1014 CLIFTON STREET NE
CEDAR RAPIDS IA 52402

Officer/Director/Trustee Five

CHRIS SCHANBACHER
SECRETARY
3161 68TH STREET
SHELLSBURG IA 52332

Organization’s website
Organization’s email HARRFAM4@FMTCS.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/6/2017
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G30 - Cancer
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 Yes
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity Yes
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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