FORM 1023-EZ for PEARL RIVER COUNTY HOSPITAL AND NURSING HOME AUXILIARY

Field Data
EIN 32-0533863
Case Number EO-2017177-000300
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PEARL RIVER COUNTY HOSPITAL AND NURSING HOME AUXILIARY
Organization’s Mailing Address P O BOX 960
City POPLARVILLE
State MS
ZIP 39470-8101
Accounting period End 12
Primary contact name LINDA AMACKER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LINDA AMACKER
PRESIDENT
62 BOB CARLISLE RD
POPLARVILLE MS 39470-8101

Officer/Director/Trustee Two

ARLYSS BROWN
VICE PRESIDENT
414 N JACKSON ST
POPLARVILLE MS 39470-8101

Officer/Director/Trustee Three

MARGARET GEORGE
2ND VICE PRESIDENT
2 GEORGE PL
LUMBERTON MS 39455

Officer/Director/Trustee Four

EDITH MILLER
TREASURER
P O BOX 960
POPLARVILLE MS 39470-8101

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/1979
Organization Incorporation State MS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E91 - Nursing, Convalescent Facilities
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 Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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