FORM 1023-EZ for HEALTHY GENERATIONS OF IREDELL INC

Field Data
EIN 86-1588694
Case Number EO-2021281-000191
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HEALTHY GENERATIONS OF IREDELL INC
Organization’s Mailing Address 509 HICKORY STREET
City STATESVILLE
State NC
ZIP 28677
Accounting period End 12
Primary contact name SCOTT HAYNES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MASON MCCULLOUGH
PRESIDENT
509 HICKORY ST
STATESVILLE NC 28677

Officer/Director/Trustee Two

DAVID LOCKHART
DIRECTOR
2300 BUFFALO SHOALS ROAD
STATESVILLE NC 28677

Officer/Director/Trustee Three

BERNARD JAMISON
SECRETARY TREASURER
621 S RACE STREET
STATESVILLE NC 28677

Officer/Director/Trustee Four

MICHAEL ADAMS
DIRECTOR
3826 SPRING CREEK LANE
ATLANTA GA 30350

Organization’s website
Organization’s email HEALTHYGENERATIONS72@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/25/2020
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P80 - Services to Promote the Independence of Specific Populations
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 MASON MCCULLOUGH
Signature Title PRESIDENT
Signature Date 10/6/2021

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