FORM 1023-EZ for KEYSTONE PUBLIC HEALTH AND SPIRITUAL CARE INC

Field Data
EIN 47-2960230
Case Number EO-2016063-000174
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KEYSTONE PUBLIC HEALTH AND SPIRITUAL CARE INC
Organization’s Mailing Address 319 SCHUYLKILL ST
City HARRISBURG
State PA
ZIP 17109
Accounting period End 12
Primary contact name DONRICO E COLDEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DONRICO COLDEN
CHAIR OF THE BOARD
319 SCHUYKILL ST
HARRISBURG PA 17110

Officer/Director/Trustee Two

EBONI BRYANT
CO CHAIR OF THE BOARD
1136 SHERWOOD FOREST DRIVE
BIRMINGHAM AL 35235

Officer/Director/Trustee Three

CARON THOMAS
FINANCE
2228 HIGHLAND CIRCLE
HARRISBURG PA 17110

Officer/Director/Trustee Four

ALLEN SMITH
SECRETARY
919 N WALNUT ST
COATESVILLE PA 19320

Officer/Director/Trustee Five

DENISE SMITH
MEMBER
919 N WALNUT ST
COATESVILLE PA 18320

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/7/2014
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
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
Signature Title
Signature Date

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