FORM 1023-EZ for KRYSTAL DAWN RETREAT

Field Data
EIN 85-3489653
Case Number EO-2021064-002138
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KRYSTAL DAWN RETREAT
Organization’s Mailing Address 265 SNEEDS MILL ROAD
City ROCKINGHAM
State NC
ZIP 28379
Accounting period End 12
Primary contact name CHRIS JUSTICE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BARBARA MCCAULEY
PRESIDENT
265 SNEEDS MILL ROAD
ROCKINGHAM NC 27408

Officer/Director/Trustee Two

LEO MCCAULEY
SECRETARY/TREASURER
265 SNEEDS MILL ROAD
ROCKINGHAM NC 28379

Organization’s website HTTPS://WWW.KRYSTALDAWNRETREAT.COM/
Organization’s email BARBARAADVANCESAS@ICLOUD.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/2/2020
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P40 - Family Services
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 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 LEO MCCAULEY
Signature Title SECRETARY/TREASURER
Signature Date 1/14/2021

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