FORM 1023-EZ for RURAL HEALTH OUTREACH CLUB

Field Data
EIN 83-1727039
Case Number EO-2019217-000218
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name RURAL HEALTH OUTREACH CLUB
Organization’s Mailing Address 7295 CAMPUS BOX NCSU
City RALEIGH
State NC
ZIP 27695-7295
Accounting period End 4
Primary contact name BRANDON GLOVER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRANDON GLOVER
PRESIDENT
7295 CAMPUS BOX NCSU
RALEIGH NC 27695-7295

Officer/Director/Trustee Two

RYAN TAYLOR
CO-PRESIDENT
7295 CAMPUS BOX NCSU
RALEIGH NC 27695-7295

Officer/Director/Trustee Three

KATHERINE HORD
CO-PRESIDENT
7295 CAMPUS BOX NCSU
RALEIGH NC 27695-7295

Officer/Director/Trustee Four

ELIZABETH MEDEMA
VICE-PRESIDENT
7295 CAMPUS BOX NCSU
RALEIGH NC 27695-7295

Officer/Director/Trustee Five

SAMANTHA AIKEN
TREASURER
7295 CAMPUS BOX NCSU
RALEIGH NC 27695-7295

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/11/18
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B80 - Student Services, Organizations of Students
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 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 BRANDON GLOVER
Signature Title PRESIDENT
Signature Date 8/1/19

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