FORM 1023-EZ for PROVIDERS OF CARE A NJ NONPROFIT CORPORATION

Field Data
EIN 83-0393632
Case Number EO-2019036-000198
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PROVIDERS OF CARE A NJ NONPROFIT CORPORATION
Organization’s Mailing Address 11 DREXEL COURT
City SICKLERVILLE
State NJ
ZIP 8081
Accounting period End 12
Primary contact name PATRICK MAY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PATRICK MAY
PRESIDENT
11 DREXEL COURT
SICKLERVILLE NJ 8081

Officer/Director/Trustee Two

ANDREW SCOTT
TREASURER
44 VETERAN DRIVE
SOUTH RIVER NJ 8882

Officer/Director/Trustee Three

EDDIE SATTERWHITE
SECRETARY
10 WATERSIDE PLAZA
NEW YORK NY 10016

Officer/Director/Trustee Four

CAROLYN HILL
DIRECTOR
45-15 COLDEN ST
FLUSHING NY 11355

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/31/05
Organization Incorporation State NJ
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: 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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name PATRICK MAY
Signature Title PRESIDENT
Signature Date 1/18/19

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