FORM 1023-EZ for INTRICATE CARE FOUNDATION

Field Data
EIN 81-5223120
Case Number EO-2017038-000134
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name INTRICATE CARE FOUNDATION
Organization’s Mailing Address 15919 W 10 MILE RD STE 208
City SOUTHFIELD
State MI
ZIP 48075
Accounting period End 12
Primary contact name KIMBERLY WILLIAMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KIMBERLY WILLIAMS
PRESIDENT, DIRECTOR
15919 W 10 MILE RD STE 208
SOUTHFIELD MI 48075

Officer/Director/Trustee Two

DENARD SUMLER
VICE PRESIDENT, DIRECTOR
9204 APPLETON
DETROIT MI 48239

Officer/Director/Trustee Three

CAMILLA GRIGGS-SPICER
SECRETARY, DIRECTOR
8731 W 9 MILE RD
OAK PARK MI 48237

Officer/Director/Trustee Four

TAMIKO DAVIS
TREASURER, DIRECTOR
23 MORROSS CIR
DEERBORN MI 48126

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/31/2017
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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
Signature Title
Signature Date

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