FORM 1023-EZ for DIVING4DIVERSITY

Field Data
EIN 86-2037048
Case Number EO-2021140-000188
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DIVING4DIVERSITY
Organization’s Mailing Address 625 NORTH MOSLEY ROAD
City ST LOUIS
State MO
ZIP 63141
Accounting period End 12
Primary contact name JEFFREY MORMOL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JEFFREY MORMOL
CEO & DIRECTOR
625 NORTH MOSLEY ROAD
ST LOUIS MO 63141

Officer/Director/Trustee Two

STACEY MORMOL
PRES & TREAS & DIRECTOR
625 NORTH MOSLEY ROAD
ST LOUIS MO 63141

Officer/Director/Trustee Three

KAREN JOHNSON
VICE PRES & DIRECTOR
12407 BIELEFIELD LANE
FLORISSANT MO 63033

Officer/Director/Trustee Four

SEAN WOODARD
SECRETARY
5137 SUSON VIEW COURT
ST LOUIS MO 63128

Organization’s website DIVING4DIVERSITY.COM
Organization’s email JMORMOL@DIVING4DIVERSITY.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/5/2021
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JEFFREY MORMOL
Signature Title CEO & DIRECTOR
Signature Date 5/14/2021

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