FORM 1023-EZ for GRACE HEALTH CARE INC
| Field | Data |
|---|---|
| EIN | 66-0890375 |
| Case Number | EO-2018057-000338 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | GRACE HEALTH CARE INC |
| Organization’s Mailing Address | 5807 PAGO PAGO |
| City | PAGO PAGO |
| State | AS |
| ZIP | 96799 |
| Accounting period End | 12 |
| Primary contact name | FLORENCE AINUU |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
FAASALALAU MATAALII
PRESIDENT
998399 OTTOVILLE ROAD
PAGO PAGO AS 96799
Officer/Director/Trustee Two
JUNE POUESI
SECRETARY
5954 PAGO PAGO
PAGO PAGO AS 96799
Officer/Director/Trustee Three
TUIATUA MATAALII
TREASURER
7030 PAGO PAGO
PAGO PAGO AS 96799
Officer/Director/Trustee Four
FLORENCE AINUU
VICE PRESIDENT
5807 PAGO PAGO
PAGO PAGO AS 96799
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 11/14/17 |
| Organization Incorporation State | AS |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | E92 - Home Health Care |
| Organization’s purpose | Charitable: Yes Religious: No Educational: Yes 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 | FLORENCE AINUU |
| Signature Title | VICE PRESIDENT |
| Signature Date | 2/22/18 |
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