FORM 1023-EZ for TRIAD LIFE CENTER

Field Data
EIN 85-4183606
Case Number EO-2021085-000027
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TRIAD LIFE CENTER
Organization’s Mailing Address 4533 VERNON CIRCLE
City KERNERSVILLE
State NC
ZIP 27284
Accounting period End 1
Primary contact name MICHAELLA WALTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NANCY DONNELL
TREASURE
4704 PENNCAL LANE
GREENSBORO NC 27404

Officer/Director/Trustee Two

RAVEN REESE
SECRETARY
30 WILLOW TRACE WAY
CLAYTON NC 27527

Officer/Director/Trustee Three

MICHAELLA WALTON
DIRECTOR
4533 VERNON CIRCLE
KERNERSVILLE NC 27284

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/24/2020
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
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 MICHAELLA WALTON
Signature Title DIRECTOR
Signature Date 2/4/2021

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