FORM 1023-EZ for MOORESVILLE CIVITAN CHARITABLE FOUNDATION

Field Data
EIN 83-2214369
Case Number EO-2018298-000298
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MOORESVILLE CIVITAN CHARITABLE FOUNDATION
Organization’s Mailing Address P O BOX 1224
City MOORESVILLE
State NC
ZIP 28115-1224
Accounting period End 9
Primary contact name JAMES N BULLARD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DEBORAH MYERS
PRESIDENT CEO
1027 WINTERFIELD DR
MOORESVILLE NC 28115

Officer/Director/Trustee Two

JAMES BULLARD
FINANCE OFFICER
1135 GRACE MEADOW DR
MOORESVILLE NC 28115-2764

Officer/Director/Trustee Three

GAYLE BEATTY
DIRECTOR
296 PONDEROSA CIRCLE
MOORESVILLE NC 28117-5500

Officer/Director/Trustee Four

RICK HUFFSTETLER
DIRECTOR
634 HIGHLAND RIDGE RD
MOORESVILLE NC 28115-7738

Officer/Director/Trustee Five

PEGGY BULLARD
DIRECTOR
1135 GRACE MEADOW DR
MOORESVILLE NC 28115-2764

Organization’s website HTTPS://WWW.MOORESVILLECIVITANCLUB.ORG/
Organization’s email JBULL3832@WINDSTREAM.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/8/18
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S80 - Community Service Clubs
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 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 JAMES BULLARD
Signature Title FINANCE OFFICER
Signature Date 10/23/18

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