FORM 1023-EZ for CAUSE CONCERN

Field Data
EIN 46-3321426
Case Number EO-2014300-000309
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CAUSE CONCERN
Organization’s Mailing Address 10826 RED OAK BATTLEBOIRO RD
City BATTLEBORO
State NC
ZIP 27809-9173
Accounting period End 12
Primary contact name JONATHAN MELVIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JONATHAN MELVIN
PRESIDENT
5264 MORNING STAR CHURCH RD
BATTLEBORO NC 27809-8891

Officer/Director/Trustee Two

JOEL MELVIN
VICE PRESIDENT
10816 RED OAK BATTLEBORO RD
BATTLEBORO NC 27809

Officer/Director/Trustee Three

DAVID REVOIR
SECRETARY
5870 BONES CUT OFF RD
ELM CITY NC 27822

Officer/Director/Trustee Four

WYATT MCGHEE
TREASURER
714 BAYBERRY LANE
NASHVILLE NC 27856

Officer/Director/Trustee Five

NICK FALK
DIRECTOR
1500 JEREMY LANE
ROCKY MOUNT NC 27803-1518

Organization’s website CAUSEANDCONCERN.COM
Organization’s email JONMRM@CENTURYLINK.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/30/2012
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: No
Religious: Yes
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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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