FORM 1023-EZ for MATTHEW 11 15

Field Data
EIN 83-2189453
Case Number EO-2018295-000264
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MATTHEW 11 15
Organization’s Mailing Address 4215 NC HWY 210
City SMITHFIELD
State NC
ZIP 27577
Accounting period End 12
Primary contact name ROBERT B OAKES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JORDAN COATES
PRESIDENT
4215 NC HWY 210
SMITHFIELD NC 27577

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/17/18
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G42 - Ear and Throat Diseases
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 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 JORDAN COATES
Signature Title PRESIDENT
Signature Date 10/19/18

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