FORM 1023-EZ for GREENBRIER VALLEY LIFECARE INC

Field Data
EIN 83-2967154
Case Number EO-2019037-000501
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GREENBRIER VALLEY LIFECARE INC
Organization’s Mailing Address 521 CHURCH STREET
City LEWISBURG
State WV
ZIP 24901
Accounting period End 12
Primary contact name MARY RENNIE ROWE LITMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAMES ROWE
SECRETARY
521 CHURCH STREET
LEWISBURG WV 24901

Officer/Director/Trustee Two

SUE DUCHARME
PRESIDENT
P O BOX 929
WHITE SULPHUR SPRING WV 24986

Officer/Director/Trustee Three

HELEN HARLESS
VICE PRESIDENT
157 SUMMIT AVENUE
LEWISBURG WV 24901

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/25/19
Organization Incorporation State WV
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L22 - Senior Citizens' Housing/Retirement Communities
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 JAMES ROWE
Signature Title SECRETARY
Signature Date 1/31/19

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