FORM 1023-EZ for SERENITY SUPPORTED SERVICES
| Field | Data |
|---|---|
| EIN | 85-4153506 |
| Case Number | EO-2021167-000325 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | SERENITY SUPPORTED SERVICES |
| Organization’s Mailing Address | 400 WEST ARLINGTON BLVD SUITE 101-H |
| City | GREENVILLE |
| State | NC |
| ZIP | 27834 |
| Accounting period End | 12 |
| Primary contact name | CAMILLAE NICHOLSON |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
ISAAC MOORE
PRESIDENT
108 WYNDHAM CIRCLE APT F
GREENVILLE NC 27858
Officer/Director/Trustee Two
DAWN CHAMBRIDGE JOHNSON
SECRETARY
5136 PARKERWOOD DRIVE
KNIGHTDALE NC 27545
Officer/Director/Trustee Three
DESHONTA KING
VICE PRESIDENT
109 AIRPORT ROAD SUITE B
KINSTON NC 28501
Officer/Director/Trustee Four
ANGELA GORHAM
TREASURER
1214 SAVIN LANDING
KNIGHTDALE NC 27545
Officer/Director/Trustee Five
CAMILLAE NICHOLSON
BOARD MEMBER
3316 EDWARDS COURT
GREENVILLE NC 27858
| Organization’s website | SERENITYSUPPORTEDSERVICES.GODADDYSITES.COM |
|---|---|
| Organization’s email | SRENITYSS@OUTLOOK.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 4/13/2021 |
| 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: 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 | CAMILLAE NICHOLSON |
| Signature Title | BOARD MEMBER |
| Signature Date | 6/14/2021 |
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