FORM 1023-EZ for CAROLINA SEXUAL WELLNESS CENTER PA

Field Data
EIN 81-1706966
Case Number EO-2017065-000267
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CAROLINA SEXUAL WELLNESS CENTER PA
Organization’s Mailing Address 102 COMMONWEALTH COURT SUITE H
City CARY
State NC
ZIP 27511
Accounting period End 12
Primary contact name KRISTA NABAR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MATTHEW TURNER
DIRECTOR
7316 MILL RIDGE ROAD
RALEIGH NC 27613

Officer/Director/Trustee Two

MICHAEL GILL
DIRECTOR
35 DRIFTWOOD LANE
ALAMEDA CA 94501

Officer/Director/Trustee Three

KRISTA NABAR
EXECUTIVE DIRECTOR
8416 BRODERICK PLACE
CARY NC 27519

Officer/Director/Trustee Four

BELA BAPAT
DIRECTOR
103 AMIABLE LOOP
CARY NC 27519

Organization’s website WWW.CAROLINASWC.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/16/2017
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F30 - Mental Health Treatment - Multipurpose and N.E.C.
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 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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