FORM 1023-EZ for SENIORS CARE OUTREACH INC

Field Data
EIN 85-3863358
Case Number EO-2021096-000395
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SENIORS CARE OUTREACH INC
Organization’s Mailing Address 4371 CROSS LN
City DECATUR
State GA
ZIP 30035
Accounting period End 12
Primary contact name SHAKURRAH SIMMONS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHAKURRAH SIMMONS
PRESIDENT
4371 CROSS LANE
DECATUR GA 30035

Officer/Director/Trustee Two

PHYLLIS GRAY
VICE PRESIDENT
2132 SOUTH STREET
DECATUR GA 30035

Officer/Director/Trustee Three

SOLOMON ISSA
SECRETARY
956 CALLY STREET
DECATUR GA 30035

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/7/2020
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: No
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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name SHAKURRAH SIMMONS
Signature Title PRESIDENT
Signature Date 3/8/2021

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