FORM 1023-EZ for FURAHA COUNSELING AND BEHAVIORAL HEALTH SERVICES INC

Field Data
EIN 84-3623613
Case Number EO-2020213-000076
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FURAHA COUNSELING AND BEHAVIORAL HEALTH SERVICES INC
Organization’s Mailing Address 5021 MIDDLESEX DR
City LOUISVILLE
State KY
ZIP 40245
Accounting period End 12
Primary contact name ERIC WINSTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ERIC WINSTON
PRESIDENT
5021 MIDDLESEX DR
LOUISVILLE KY 40245

Officer/Director/Trustee Two

TANCE BREWER
SECRETARY
5021 MIDDLESEX DR
LOUISVILLE KY 40245

Officer/Director/Trustee Three

TRACY DAVIS
DIRECTOR
5021 MIDDLESEX DR
LOUISVILLE KY 40245

Officer/Director/Trustee Four

ROBERT BELL
DIRECTOR
5021 MIDDLESEX DR
LOUISVILLE KY 40245

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/7/2019
Organization Incorporation State KY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F60 - Counseling, Support Groups
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 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 ERIC WINSTON
Signature Title PRESIDENT
Signature Date 7/29/2020

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