FORM 1023-EZ for NICKS NEVERLAND SENIOR SANCTUARY

Field Data
EIN 47-2077648
Case Number EO-2015054-000175
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NICKS NEVERLAND SENIOR SANCTUARY
Organization’s Mailing Address 3138 J E CARPENTER RD
City LINCOLNTON
State NC
ZIP 28092
Accounting period End 12
Primary contact name ANTOINETTE CARPENTER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ANTOINETTE CARPENTER
DIRECTOR
3138 J E CARPENTER RD
LINCOLNTON NC 28092

Officer/Director/Trustee Two

GENETE BOWEN
PRESIDENT
1425 N BRADLEY UNIT D
SANTA MARIA CA 93454

Officer/Director/Trustee Three

WILLIAM CARPENTER
TREASURER
3138 J E CARPENTER
LINCOLNTON NC 28092

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/9/2011
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D11 - Single Organization Support
Organization’s purpose Charitable: No
Religious: No
Educational: No
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 Yes
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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