FORM 1023-EZ for GOLDEN CORNER RESPITE CARE PROGRAM

Field Data
EIN 81-2580284
Case Number EO-2016201-000265
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name GOLDEN CORNER RESPITE CARE PROGRAM
Organization’s Mailing Address 214 NORTHAMPTON RD
City SENECA
State SC
ZIP 29672-6962
Accounting period End 12
Primary contact name KATHY BIRKETT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KATHY BIRKETT
PROGRAM DIRECTOR
214 NORTHAMPTON RD
SENECA SC 29672-6962

Officer/Director/Trustee Two

GAIL MARION
SECRETARY/TREASURER
214 NORTHAMPTON RD
SENECA SC 29672-6962

Officer/Director/Trustee Four

LOU LEFFLER
COCHAIRMAN
214 NORTHAMPTON RD
SENECA SC 29672-6962

Officer/Director/Trustee Five

BETTY STEVENS
CHARIMAN
214 NORTHAMPTON RD
SENECA SC

Organization’s website
Organization’s email GOLDENCORNERRESPITECARE@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/15/2016
Organization Incorporation State SC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G83 - Alzheimer's Disease
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 Yes
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
Signature Title
Signature Date

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