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IAMU “Grants & Loans”

 

iamulogopngc

 

IAMU is a nonprofit affiliate of Acts Ministry, Inc. It seeks to “Promote the use
of natural products including plants for spirtual and physical healing.” It is
located at 258 West 3rd Street Kansas City, Missouri 64105.
It’s telephone 
number is 816-743-9937 and Missouri’s Best Location on the web is:
http://www.missourisbest.com/category/kansas-city/non-profit-kansas-city/

IAMU GRANT APPLICATION COVER SHEET

 
Grant maker to whom this application is submitted: IAMU c/o Acts Ministry

Online submission or sent to

1736 E. Sunshine, Suite 216

Springfield, Mo. 65804

  Application Date:  

 

Org Website:  
  Applicants Legal Name: (as shown on IRS Letter of Determination)  
  Doing Business As: (if different from legal name)  
  EIN #:  
  Address:  

 

  City:  

 

State:   Zip code:  
  Telephone #:  

 

   
  Executive Director:

(or Top Executive)

 

 

(Please include prefix and title)

Phone #:  
  Email Address:  
  Main Contact(s) for this Proposal:  

 

(Please include prefix and title)

Phone #:  
  Email Address:  
  Board President:  

 

 

Phone #:  
  Email Address:  

 

Applicant’s tax exempt status/ IRS designation (e.g. 501(c)(3), 501(c)(9), etc)  

 

 

(Attach a copy of the IRS Letter of Determination- NOTE- this is not the state sales and use tax exemption certificate.  If there has been a name change provide copies of the amended state certificate of incorporation and amended IRS Letter of Determination)

If not a 501(c)(3) Nonprofit, then who is fiscal agent?  

 

 

 

(Attach a copy of the written agreement from fiscal agent plus fiscal agent’s contact information and EIN)

 

Organization’s Mission Statement and Vision Statement
 

 

Type of request (check one): Note, not all funders support each type of request. Check with individual grantmaker.
[  ] Grant [  ] Project/Program
[  ] Loan [  ] Other (explain)
[  ]
 
[  ] New Project [  ] Existing Project [  ] Expansion of Existing Project

 

 

Project/Campaign Name:

(if general operating please indicate)

 

 
Proposal Summary – In 500 words or less summarize the purpose of this request. May also attach video address.
 
Funding Period Requested: (be specific) /    /     through   12   / 1   /17 Amount Requested: $
Total Project Budget for this period: (not required if general operating request) $ Attach Line Item Budget:  
Organization Fiscal Year:  /    /    through     /    /

 

Geographic Area(s) Served:

(include specific counties)

 

 

 

(For this project.  If general operations support, for this organization.)

 

Attach Copies of Key Personnel Resumes  

 

 

 

 

 

 

2

 

Agreement
I certify to the best of my knowledge, that all information included in this proposal is correct.  The tax exempt status of this organization is still in effect.  If a grant is awarded to this organization, then the proceeds of that grant will not be distributed or used to benefit any organization or individual supporting or engaged in unlawful activities.

 

In compliance with the USA Patriot Act and other counterterrorism laws, I certify that all funds received from this funder will be used in compliance with all applicable anti-terrorist financing and asset control laws, statutes, and executive orders.

 

 

   

 

 

 

 

 

Signature, Executive Director(Top Executive)

(or authorizing official on behalf of the organization)

 

 

Date

 

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