FORM 1023-EZ for NORTHERN NECK HEALTH INC

Field Data
EIN 82-2249307
Case Number EO-2017207-000151
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NORTHERN NECK HEALTH INC
Organization’s Mailing Address PO BOX 633 - 44 OLD GLEBE POINT RD
City BURGESS
State VA
ZIP 22432
Accounting period End 12
Primary contact name LAVERNE MORROW CARTER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GWEN KEANE
CHAIRMAN
PO BOX 1902
KILMARNOCK VA 22482

Officer/Director/Trustee Two

LAVERNE MORROW CARTER
PRESIDENT
PO BOX 374
WICOMICO CHURCH VA 22579-0374

Officer/Director/Trustee Three

DAISY BURRELL
SECRETARY-TREASURER
PO BOX 152
CALLAO VA 22435

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/21/2017
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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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