FORM 1023-EZ for PERSON COUNTY MEMORIAL FOUNDATION INC

Field Data
EIN 56-2015158
Case Number EO-2019177-000329
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PERSON COUNTY MEMORIAL FOUNDATION INC
Organization’s Mailing Address 238 CHARLES CIRCLE
City ROXBORO
State NC
ZIP 27573
Accounting period End 9
Primary contact name ALAN HICKS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ALAN HICKS
CHAIR
238 CHARLES CIRCLE
ROXBORO NC 27573

Officer/Director/Trustee Two

TOM ALEXANDER
SECRETARY
421 SOUTH MAIN STREET
ROXBORO NC 27573

Officer/Director/Trustee Three

GORDON CARVER
TRESURER
32 DENADA PATH
ROXBORO NC 27573

Officer/Director/Trustee Four

CAROLYN WILLIAMS
EXECUTIVE DIRECTOR
474 WESTOVER DRIVE
ROXBORO NC 27573

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/2/97
Organization Incorporation State NC
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: Yes
Scientific: Yes
Literary: Yes
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ALAN HICKS
Signature Title CHAIR
Signature Date 6/24/19

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