FORM 1023-EZ for CARELINE HOSPICE FOUNDATION

Field Data
EIN 87-1491387
Case Number EO-2021252-000263
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CARELINE HOSPICE FOUNDATION
Organization’s Mailing Address 103 S JACKSON ST
City JACKSON
State MI
ZIP 49201
Accounting period End 12
Primary contact name CRISTINE KING
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

EMILY KIELHORN
PRESIDENT AND DIRECTOR
103 S JACKSON ST
JACKSON MI 49201

Officer/Director/Trustee Two

BOB MICHAELS
SECRETARY AND DIRECTOR
103 S JACKSON ST
JACKSON MI 49201

Officer/Director/Trustee Three

GLORIA MICHAELS
TREASURER AND DIRECTOR
103 S JACKSON ST
JACKSON MI 49201

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/16/2021
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E60 - Health Support Services
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: Yes
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 EMILY KIELHORN
Signature Title PRESIDENT AND DIRECTOR
Signature Date 9/7/2021

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