| Field | Data |
|---|---|
| EIN | 85-3870134 |
| Case Number | EO-2021083-000569 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | DOMINION HEALTH CARE FOUNDATION |
| Organization’s Mailing Address | 5831 SUNNINGDALE LANE |
| City | HOPE MILLS |
| State | NC |
| ZIP | 28348 |
| Accounting period End | 6 |
| Primary contact name | PEVIN WILLIAMS |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
PEVIN WILLIAMS
PRESIDENT
5831 SUNNINGDALE LANE
HOPE MILLS NC 28348
TRACY BROOKS
SECRETARY
2625 LAKE POINT DRIVE 921
GRAND PRAIRIE TX 75050
ANITA MCCLURE
TREASURER
3029 HERNES DRIVE
OLYMPIA FIELDS IL 60461
ADRIAN WELLS
OFFICER
12850 HEY 9 NORTH SUITE 600-113
ALPHARETTA GA 30004
| Organization’s website | |
|---|---|
| Organization’s email | PEVINDHCIS.CO@GMAIL.COM |
| Organization Incorporated | No |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 10/1/2020 |
| Organization Incorporation State | GA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | B82 - Scholarships, Student Financial Aid Services, Awards |
| Organization’s purpose | Charitable: Yes Religious: No Educational: Yes 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 | Yes |
| 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 | PEVIN WILLIAMS |
| Signature Title | PRESIDENT |
| Signature Date | 11/15/2020 |
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