FORM 1023-EZ for PROSPERITY HEALTHCARE

Field Data
EIN 46-1853787
Case Number EO-2016356-000300
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PROSPERITY HEALTHCARE
Organization’s Mailing Address 7209 EAST WT HARRIS BLVD STE J 105
City CHARLOTTE
State NC
ZIP 28227
Accounting period End 12
Primary contact name PAULA SPEIGHT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PAULA SPEIGHT
PRESIDENT
7209 EAST WT HARRIS BLVD STE J 105
CHARLOTTE NC 28227

Officer/Director/Trustee Two

SONIA DALLAS
SECRETARY
410 VICKERY DRIVE
CHARLOTTE NC 28215

Officer/Director/Trustee Three

JOHNNY TURNAGE III
TREASURER
2400 COLLEGE APT 714
COUNCIL BLUFFS IA 51503

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/13/2013
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B1A -
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 Yes
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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