FORM 1023-EZ for BOHEMIA CARES

Field Data
EIN 82-3918704
Case Number EO-2018068-000179
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BOHEMIA CARES
Organization’s Mailing Address 700 LEHMAN DRIVE
City JACKSONVILLE
State AR
ZIP 72076
Accounting period End 12
Primary contact name VERLANCIE TUCKER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARQUIS COOPER
BOARD MEMBER
201 E 21ST STREET
LITTLE ROCK AR 72206

Officer/Director/Trustee Two

SHAYLONDA JACKSON
BOARD MEMBER
24 AUGUSTA COURT APT 202
LITTLE ROCK AR 72210

Officer/Director/Trustee Three

KAREN SHELTON-WARREN
BOARD MEMBER
1314 FRANK
NORTH LITTLE ROCK AR 72114

Officer/Director/Trustee Four

VERLANCIE TUCKER
DIRECTOR
700 LEHMAN DRIVE
JACKSONVILLE AR 72076

Organization’s website WWW.BOHEMIACARES.ORG
Organization’s email BOHEMIACARES@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/8/18
Organization Incorporation State AR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W70 - Leadership Development
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 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 VERLANCIE TUCKER
Signature Title DIRECTOR
Signature Date 3/7/18

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