FORM 1023-EZ for CHAMPION HOUSE OF CARE PROJECT ONEINC

Field	Data
EIN	83-3048170
Case Number	EO-2019035-000384
Form 1023-EZ version	12018
Eligibility Worksheet	1
Organization Name	CHAMPION HOUSE OF CARE PROJECT ONEINC
Organization’s Mailing Address	5907 BARRINGTON DR
City	CHARLOTTE
State	NC
ZIP	28215
Accounting period End	12
Primary contact name	JANETTE KINARD
Primary contact phone	[Hidden]
Primary contact phone extension	[Hidden]
Primary contact fax	[Hidden]
User fee submitted	$275.00

Officer/Director/Trustee One

JANETTE KINARD
EXECUTIVE DIRECTOR
5907 BARRINGTON DR
CHARLOTTR NC 28215

Officer/Director/Trustee Two

COREY JAMISON
DIRECTOR/TRUSTEE
SAME
CHARLOTTE NC 28215

Officer/Director/Trustee Three

TRACY MOORE
TRESURE/TRUSTEE
SAME
CHARLOTTE NC 28215

Officer/Director/Trustee Four

WILLIAM LONGMIRE
VICE PRESIDENT
SAME
CHARLOTTE NC 28215

Officer/Director/Trustee Five

RANDOLPH KEYS
SECRETARY/
SAME
CHARLOTTE NC 28215

Organization’s website	CHAMPIONHOUSEOFCARE
Organization’s email	CHAMPIONHOUSEOFCARE@GMAIL.COM
Organization Incorporated	Yes
Organization trust	No
Necessary Organizing Documents	Yes
Organization Incorporation Date	1/4/19
Organization Incorporation State	NC
Contains Limitation	Yes
Does not expressly empower	Yes
Contains dissolution	Yes
National Taxonomy of Exempt Entities (NTEE) code	E70 - Public Health Program (Includes General Health and Wellness Promotion 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	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	JANETTE KINARD
Signature Title	EXECUTIVE DIRECTOR
Signature Date	1/9/19
EIN	83-3048170
Case Number	EO-2019035-000384
Form 1023-EZ version	12018
Eligibility Worksheet	1
Organization Name	CHAMPION HOUSE OF CARE PROJECT ONE INC
Organization’s Mailing Address	5907 BARRINGTON DR
City	CHARLOTTE
State	NC
ZIP	28215
Accounting period End	12
Primary contact name	JANETTE KINARD
Primary contact phone	[Hidden]
Primary contact phone extension	[Hidden]
Primary contact fax	[Hidden]
User fee submitted	$275.00