FORM 1023-EZ for CS WHITE INC

Field Data
EIN 82-5291719
Case Number EO-2018152-000262
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CS WHITE INC
Organization’s Mailing Address 6319 RAEFORD ROAD APT 30
City FAYETTEVILLE
State NC
ZIP 28304
Accounting period End 12
Primary contact name SAMANTHA RENEE WHITE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SAMANTHA WHITE
PRESIDENT/CEO (FOUNDING DIRECTOR)
6319 RAEFORD ROAD APT 30
FAYETTEVILLE NC 28304

Officer/Director/Trustee Two

MARCUS DUPREE
COMMUNITY SERVICE DIRECTOR
226 IRENE STREET
FAYETTEVILLE NC 28301

Officer/Director/Trustee Three

VIVIAN FOLK
CHIEF FINANCIAL DIRECTOR
6146 TUDOR PLACE
LINDEN NC 28356

Officer/Director/Trustee Four

STEPHANIE INGRAM
EVENTS/PLANNING COORDINATOR
2301 LILAC LANE
RALIEGH NC 27612

Officer/Director/Trustee Five

JAMES MOODY
SECRETARY
38 DEER HAVEN DRIVE
ANGIER NC 27501

Organization’s website WWW.CSWHITEINC.ORG
Organization’s email MENTOR@CSWHITEINC.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/10/18
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 Yes
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 SAMANTHA WHITE
Signature Title PRESIDENT/CEO (FOUNDING DIRECTOR)
Signature Date 5/30/18

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