FORM 1023-EZ for HIS MISSION CHURCH INC

Field Data
EIN 81-2733191
Case Number EO-2016221-000383
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HIS MISSION CHURCH INC
Organization’s Mailing Address 130 N MONROE
City WILLIAMSPORT
State IN
ZIP 47993
Accounting period End 12
Primary contact name MICHAEL HUTCHISON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MELISSA BAROFF
TREASURER
111 TAMI LANE
WILLIAMSPORT IN 47993

Officer/Director/Trustee Two

LARRY VANDAME
CHAIRMAN
130 N MONROE
WILLIAMSPORT IN 47993

Officer/Director/Trustee Three

JENIFER GREESON
SECRETARY
130 N MONROE
WILLIAMSPORT IN 47993

Organization’s website N/A
Organization’s email MIKE@BACTRIANLLC.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/10/2016
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: No
Religious: Yes
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
Signature Title
Signature Date

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