FORM 1023-EZ for HOLLY HILL LIFE CHANGING CENTER INC

Field Data
EIN 47-2680262
Case Number EO-2015026-000293
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HOLLY HILL LIFE CHANGING CENTER INC
Organization’s Mailing Address PO BOX 8605
City GREENVILLE
State NC
ZIP 27835
Accounting period End 12
Primary contact name DAVID MOODY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DAVID MOODY
PRESIDENT
419 ANGIER COURT
WINTERVILLE NC 28590

Officer/Director/Trustee Two

RODGER HARRIS
VICE PRESIDENT
302 TERRACE COURT
GREENVILLE NC 27834

Officer/Director/Trustee Three

WALTER COUNCIL
TREASURER
410 WEST 5TH STREET
GREENVILLE NC 27834

Officer/Director/Trustee Four

JAMES TRIPP
BOARD MEMBER
PO BOX 8063
GREENVILLE NC 27835

Officer/Director/Trustee Five

CHARLES HOOKS
BOARD MEMBER
205 WOODSIDE DRIVE
GREENVILLE NC 27834

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/30/2005
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O55 - Youth Development - Religious Leadership
Organization’s purpose Charitable: Yes
Religious: Yes
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
Signature Title
Signature Date

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