FORM 1023-EZ for FIRST CHOICE COMMUNITY CARE SERVICES INC

Field Data
EIN 84-4178087
Case Number EO-2020135-000079
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FIRST CHOICE COMMUNITY CARE SERVICES INC
Organization’s Mailing Address 17 WARREN RD STE 1-A
City PIKESVILLE
State MD
ZIP 21208
Accounting period End 12
Primary contact name NADIA SURIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NADIA SURIN
PRESIDENT
4103 TURF RUN CIRCLE
RANDALLSTOWN MD 21133

Officer/Director/Trustee Two

KIMBERLY BRISCOE-ASANTE
SECRETARY
3203 SEQUOIA AVE
BALTIMORE MD 21215

Officer/Director/Trustee Three

OLUBUSOLA FAWEHINMI
TREASURER
7507 MAURY RD
WINDSOR MILL MD 21244

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/2020
Organization Incorporation State MD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F20 - Alcohol, Drug and Substance Abuse, Dependency Prevention and Treatment
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 NADIA SURIN
Signature Title PRESIDENT
Signature Date 5/12/2020

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