FORM 1023-EZ for HOUSE OF RAHAB

Field Data
EIN 61-1845844
Case Number EO-2017167-000134
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HOUSE OF RAHAB
Organization’s Mailing Address 2656 ANDERSON ROAD
City BURLINGTON
State NC
ZIP 27217
Accounting period End 12
Primary contact name SHERRELL D LEA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHERRELL LEA
EXECUTIVE DIRECTOR
2710 ANDERSON ROAD
BURLINGTON NC 27217

Officer/Director/Trustee Two

TAMIKA YARBOROUGH
ASSISTANT EXECUTIVE DIRECTOR
4061 STONECREST DRIVE APT 102
BURLINGTON NC 27215

Officer/Director/Trustee Three

DOROTHY DAY
TREASURER
2115 S ASHLAND DRIVE
BURLINGTON NC 27217

Officer/Director/Trustee Four

LENORE TWITTY
SECRETARY
410 FERNWAY DRIVE
BURLINGTON NC 27217

Organization’s website OUTOFEGYPT.ORG
Organization’s email SHERRELLLEA@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/20/2016
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F21 - Alcohol, Drug Abuse, Prevention Only
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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