FORM 1023-EZ for MY PARENTS HOME CORPORATION

Field Data
EIN 84-2824673
Case Number EO-2019240-000044
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MY PARENTS HOME CORPORATION
Organization’s Mailing Address 4225 OCEANSIDE BLVD SUITE H-241
City OCEANSIDE
State CA
ZIP 92058
Accounting period End 12
Primary contact name SEDRIC HILL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SAM TERRY
CEO
443 BLUEBERRY CIRCLE
OCEANSIDE CA 92058

Officer/Director/Trustee Two

KATHY TERRY
PRESIDENT
443 BLUEBERRY CIRCLE
OCEANSIDE CA 92058

Officer/Director/Trustee Three

KRISTEN KONIG
SECRETARY
16010 SW DEWBERRY LN
TIGARD OR 97223

Officer/Director/Trustee Four

DARRYL GRAVES
DIRECTOR
322 HANOVER AVE APT 443
OAKLAND CA 94606

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/6/19
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E92 - Home Health Care
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 KATHY TERRY
Signature Title PRESIDENT
Signature Date 8/23/19

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