FORM 1023-EZ for SOUL CLINIC OF KENTUCKIANA INC
| Field | Data |
|---|---|
| EIN | 27-4043845 |
| Case Number | EO-2019259-000629 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | SOUL CLINIC OF KENTUCKIANA INC |
| Organization’s Mailing Address | 417 EAST BROADWAY |
| City | LOUISVILLE |
| State | KY |
| ZIP | 40202 |
| Accounting period End | 12 |
| Primary contact name | DUSTIN COX |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
DUSTIN COX
EXECUTIVE DIRECTOR
417 EAST BROADWAY
LOUISVILLE KY 40202
Officer/Director/Trustee Two
KEN MCGREW
GENERAL MEMBER
417 EAST BROADWAY
LOUISVILLE KY 40202
Officer/Director/Trustee Three
SAMANTHA SIMMS
SECRETARY
417 EAST BROADWAY
LOUISVILLE KY 40202
| Organization’s website | WWW.SOULCLINICOFKENTUCKIANA.ORG |
|---|---|
| Organization’s email | SOULCLINICOFKENTUCKIANAINC@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 11/1/11 |
| Organization Incorporation State | KY |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | P50 - Personal Social Services |
| 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 | Yes |
| 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 | DUSTIN COX |
| Signature Title | EXECUTIVE DIRECTOR |
| Signature Date | 9/11/19 |
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