FORM 1023-EZ for SAVING GRACE-HOME FOR TEENAGE CHILDREN INCORPORATED

Field Data
EIN 82-1441493
Case Number EO-2017153-000420
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SAVING GRACE-HOME FOR TEENAGE CHILDREN INCORPORATED
Organization’s Mailing Address 1882 WOODSTONE DRIVE
City WINSTON SALEM
State NC
ZIP 27127-6110
Accounting period End 12
Primary contact name DR STACY Y KELLEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DR STACY Y KELLEY
FOUNDER CEO
18820WOODSTONE DRIVE
WINSTON SALEM NC 27127-6110

Officer/Director/Trustee Two

CAROL M DAVIS
VICE PRESIDENT
205 SEDGE MEADOW DRIVE
WINSTON SALEM NC 27107

Officer/Director/Trustee Three

MANUEL H COMAS
TREASURY
1709 TROSPER ROAD
GREENSBORO NC 27455

Officer/Director/Trustee Four

MARQUISE KELLEY
SECRETARY
1530 THRESHER LANE
WINSTON SALEM NC 27127-6110

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/6/2017
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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