FORM 1023-EZ for GRACE ADULT CARE

Field Data
EIN 85-2043768
Case Number EO-2020259-000030
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GRACE ADULT CARE
Organization’s Mailing Address 7213 ROBERT ULRICH AVE
City DAYTON
State OH
ZIP 45415
Accounting period End 12
Primary contact name MOGES FESSEHA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MOGES FESSEHA
DIRECTOR
7213 ROBERT ULRICH AVE
DAYTON OH 45415

Officer/Director/Trustee Two

ASTER WASEHUN
OFFICER
7213 ROBERT ULRICH AVE
DAYTON OH 45415

Officer/Director/Trustee Three

RHODAS MOGES
OFFICER
7213 ROBERT ULRICH AVE
DAYTON OH 45415

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/20/2020
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P73 - Group Home (Long Term)
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name MOGES FESSEHA
Signature Title DIRECTOR
Signature Date 9/11/2020

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