FORM 1023-EZ for DOC HILLS FAMILY CARE HOME

Field Data
EIN 83-4294830
Case Number EO-2019126-000328
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DOC HILLS FAMILY CARE HOME
Organization’s Mailing Address PO BOX 1123
City HAMLET
State NC
ZIP 28345
Accounting period End 12
Primary contact name LUARLEEN HILL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

EDWARD HILL
PUBLIC RELATIONS ADMINISTRATOR
242 MCGIRT ROAD
HAMLET NC 28345-9124

Officer/Director/Trustee Two

JAMES HAMILTON
OPERATIONS DIRECTOR
302 SPRING STREET
HAMLET NC 28345-9124

Officer/Director/Trustee Three

DENISE COZART
MENTAL HEALTH CONSULTANT
363 EARLE FRANKLIN DR
HAMLET NC 28345-9124

Officer/Director/Trustee Four

LUARLEEN HILL
ADMINISTRATOR
242 MCGIRT ROAD
HAMLET NC 28345-9124

Officer/Director/Trustee Five

ASHA ALVARADO
ADMINISTRATIVE ASSISTANT
242 MCGIRT ROAD
HAMLET NC 28345-9124

Organization’s website
Organization’s email LHILL7585@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/19/19
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P70 - Residential, Custodial Care
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 LUARLEEN HILL
Signature Title ADMINISTRATOR
Signature Date 5/2/19

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