FORM 1023-EZ for NORTH CAROLINA INDIAN SENIOR CITIZENS CONFERENCE

Field Data
EIN 86-2236205
Case Number EO-2021093-000725
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name NORTH CAROLINA INDIAN SENIOR CITIZENS CONFERENCE
Organization’s Mailing Address 216 WOODBURY LANE
City GASTONIA
State NC
ZIP 28056-1334
Accounting period End 12
Primary contact name JESSIE JACOS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JESSIE JACOBS
PRESIDENT
216 WOODBURY LANE
GASTONIA NC 28056-1334

Officer/Director/Trustee Two

VICKIE NEWTON
VICE PRESIDENT
206 FOX LAKE DRIVE
CLINTON NC 28328-3108

Officer/Director/Trustee Three

PEGGY AMMONS
SEC/TREASURY
1889 TAYLORS BRIDGE HWY
CLINTON NC 28328-9298

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/28/2021
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B11 - Single Organization Support
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JESSIE JACOBS
Signature Title PRESIDENT
Signature Date 3/2/2021

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