FORM 1023-EZ for SOUTH CAROLINA YOUTH DIABETES ASSOCIATION

Field Data
EIN 47-1776514
Case Number EO-2014262-000336
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SOUTH CAROLINA YOUTH DIABETES ASSOCIATION
Organization’s Mailing Address P O BOX 85
City HEATH SPRINGS
State SC
ZIP 29058
Accounting period End 12
Primary contact name CHRIS HOUK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CHRIS HOUK
TREASURER
85 LICK FORK ROAD
EDGEFIELD SC 29824

Officer/Director/Trustee Two

KIRBY BOWEN
PRESIDENT
205 GLEN EAGLE DRIVE
SUMMERVILLE SC 29483

Officer/Director/Trustee Three

TRACI SCOTT
SECRETARY
524 WOODLAND DRIVE
KERSHAW SC 29067

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/12/2014
Organization Incorporation State SC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G80 - Specifically Named Diseases
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 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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