FORM 1023-EZ for RAILCARE HEALTH

Field Data
EIN 82-1693813
Case Number EO-2017157-000204
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name RAILCARE HEALTH
Organization’s Mailing Address 7600 MALBEC COURT
City KERNERSVILLE
State NC
ZIP 27284
Accounting period End 12
Primary contact name KEVIN TRAVIA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KEVIN TRAVIA
CEO AND CHAIRMAN
7600 MALBEC COURT
KERNERSVILLE NC 27284

Officer/Director/Trustee Two

RICKY ZHENG
GOVERNANCE COMMITTEE CHAIR
105 VILLAGE WALK WEST
LUMBERTON NC 28358

Officer/Director/Trustee Three

KATIE TRAVIA
COMMUNICATIONS COMMITTEE CHAIR
7600 MALBEC COURT
KERNERSVILLE NC 27284

Officer/Director/Trustee Four

ROBERT TRAVIA
ETHICS AND QUALITY COMMITTEE CHAIR
7600 MALBEC COURT
KERNERSVILLE NC 27284

Officer/Director/Trustee Five

ABBI SHUMAKER
OPERATIONS COMMITTEE CHAIR
13400 MAYES ROAD
HUNTERSVILLE NC 28078

Organization’s website WWW.RAILCAREHEALTH.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/12/2017
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E21 - Community Health Systems
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 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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