FORM 1023-EZ for JORDAN HOUSE FOUNDATION INC

Field Data
EIN 83-2058831
Case Number EO-2018317-000515
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name JORDAN HOUSE FOUNDATION INC
Organization’s Mailing Address 3139 METTHAME DR
City FAYETTEVILLE
State NC
ZIP 28306
Accounting period End 12
Primary contact name BOBBY WILLIAMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BOBBY WILLIAMS
EXECUTIVE DIRECTOR
3139 METTHAME DR
FAYETTEVILLE NC 28306

Officer/Director/Trustee Two

SHIRLEY SMITH
PRESIDENT
614 DOCKERY RD
RAEFORD NC 28376

Officer/Director/Trustee Three

TYRELL RILEY
VICE PRESIDENT
2301 HYDA PARK BLVD
NIAGARA FALLS NY 14305

Officer/Director/Trustee Four

CRAIG ALFORD
SECRETARY/TREASURER
514 DOCKERY RD
RAEFORD NC 28376

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/24/18
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 BOBBY WILLIAMS
Signature Title EXECUTIVE DIRECTOR
Signature Date 11/11/18

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