FORM 1023-EZ for SHALOM CHRISTIAN COUNSELING INC

Field Data
EIN 86-3416328
Case Number EO-2021152-000687
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SHALOM CHRISTIAN COUNSELING INC
Organization’s Mailing Address 7588 LEXINGTON CLUB BLVD UNIT B
City DELRAY BEACH
State FL
ZIP 33446
Accounting period End 12
Primary contact name SARAH NICKLAS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SABEENA WILLIAM
PRESIDENT
7588 LEXINGTON CLUB BLVD UNIT B
DELRAY BEACH FL 33446

Officer/Director/Trustee Two

SARAH NICKLAS
TREASURER
7588 LEXINGTON CLUB BLVD UNIT B
DELRAY BEACH FL 33446

Officer/Director/Trustee Three

CARY WEISBAUL
SECRETARY
7588 LEXINGTON CLUB BLVD UNIT B
DELRAY BEACH FL 33446

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/28/2021
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
Organization’s purpose Charitable: Yes
Religious: Yes
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 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 SARAH NICKLAS
Signature Title TREASURER
Signature Date 5/29/2021

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