FORM 1023-EZ for CAROLINA PEDIATRIC ATTENTION LOVE AND SUPPORT

Field Data
EIN 82-3120468
Case Number EO-2020099-000128
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CAROLINA PEDIATRIC ATTENTION LOVE AND SUPPORT
Organization’s Mailing Address BOX 145 FPG STUDENT UNION CB 5210
City CHAPEL HILL
State NC
ZIP 27599-0001
Accounting period End 5
Primary contact name FAHAD SHAH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MEGHAN FOX
DIRECTOR
406 BERLIN WAY
MORRISVILLE NC 27560-9105

Officer/Director/Trustee Two

FAHAD SHAH
CEO
305 GRASSY POINT ROAD
APEX NC 27502-3771

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/11/2019
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T50 - Philanthropy, Charity, Voluntarism Promotion, 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 FAHAD SHAH
Signature Title CEO
Signature Date 4/6/2020

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