FORM 1023-EZ for PROFESSIONAL CARE HOUSING INC

Field Data
EIN 85-3154588
Case Number EO-2021100-000185
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PROFESSIONAL CARE HOUSING INC
Organization’s Mailing Address 3738 NATRONA CT
City ELLENWOOD
State GA
ZIP 30294
Accounting period End 12
Primary contact name PAMELA COLLINS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PAMELA COLLINS
PRESIDENT, DIRECTOR
3738 NATRONA CT
ELLENWOOD GA 30294

Officer/Director/Trustee Two

MIA HROBROWSKI
SECRETARY, DIRECTOR
3738 NATRONA CT
ELLENWOOD GA 30294

Officer/Director/Trustee Three

RASHAUN SANDERS
TREASURER, DIRECTOR
3738 NATRONA CT
ELLENWOOD GA 30294

Officer/Director/Trustee Four

MICHEAL GREENE
DIRECTOR
3738 NATRONA CT
ELLENWOOD GA 30294

Officer/Director/Trustee Five

ALISA ANDERSON
DIRECTOR
3738 NATRONA CT
ELLENWOOD GA 30294

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/23/2020
Organization Incorporation State GA
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 Yes
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 PAMELA COLLINS
Signature Title PRESIDENT, DIRECTOR
Signature Date 3/25/2021

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