FORM 1023-EZ for CONTINUUM HOSPICE FOUNDATION INC

Field Data
EIN 38-4105838
Case Number EO-2019066-000006
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CONTINUUM HOSPICE FOUNDATION INC
Organization’s Mailing Address 110 HIGHWAY 70 EAST SUITE 110
City GARNER
State NC
ZIP 27529
Accounting period End 9
Primary contact name ANDY KOHA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANDY KOHA
MEMBER
110 HIGHWAY 70 EAST SUITE 110
GARNER NC 27529

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/29/19
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T21 - Corporate Foundations
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 Yes
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 ANDY KOHA
Signature Title MEMBER
Signature Date 3/4/19

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