FORM 1023-EZ for CO-MED ADULT DAY CARE

Field Data
EIN 47-4868579
Case Number EO-2017097-000413
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CO-MED ADULT DAY CARE
Organization’s Mailing Address 6100 PRIMACY PARKWAY
City MEMPHIS
State TN
ZIP 38119
Accounting period End 12
Primary contact name TERRY WINGO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LYQUALA BUFORD
EXECUTIVE DIRECTOR
4719 FURRY COVE
MEMPHIS TN 38125

Officer/Director/Trustee Two

TERRY WINGO
VICE PRSIDENT
1447 DRAIN RD
WEIR MS 39772

Officer/Director/Trustee Three

MARIEL WHITFIELD
SECRETARY
POBOX 22
NOXAPATER MS 39346

Officer/Director/Trustee Four

RICKEY CULBERSON
BOARD MEMBER
202 HILL STREET
LOUISVILLE MS 39339

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/1/2014
Organization Incorporation State TN
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 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
Signature Title
Signature Date

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