FORM 1023-EZ for ST DOMINIC OF SILOS REHABILITATIONSERVICES INC

Field Data
EIN 47-4191449
Case Number EO-2015159-000510
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ST DOMINIC OF SILOS REHABILITATIONSERVICES INC
Organization’s Mailing Address 425 OAK SPRINGS DR
City SEGUIN
State TX
ZIP 78155
Accounting period End 12
Primary contact name WILLIAM G PEEK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

WILLIAM PEEK
DIRECTOR
425 OAK SPRINGS DR
SEGUIN TX 78155

Officer/Director/Trustee Two

EILEEN PEEK
DIRECTOR
425 OAK SPRINGS DR
SEGUIN TX 78155

Officer/Director/Trustee Three

KURT DANIEL
DIRECTOR
2308 WAYSIDE DR
BRYAN TX 77802

Officer/Director/Trustee Four

KARA DANIEL
DIRECTOR
2308 WAYSIDE DR
BRYAN TX 77802

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/8/2015
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code J21 - Vocational Counseling, Guidance and Testing
Organization’s purpose Charitable: No
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 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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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