FORM 1023-EZ for PINECREST MEDICAL CARE FACILITY AUXILIARY

Field Data
EIN 84-2558348
Case Number EO-2019226-000291
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PINECREST MEDICAL CARE FACILITY AUXILIARY
Organization’s Mailing Address W3633 US HWY 2/41
City SPALDING
State MI
ZIP 49886
Accounting period End 12
Primary contact name SLOANE SKINNER CARLOUGH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHIRLEY CHARLIER
DIRECTOR; PRESIDENT
W3633 US HWY 2/41
SPALDING MI 49886

Officer/Director/Trustee Two

CHERYL ROCHON
DIRECTOR; SECRETARY
W3633 US HWY 2/41
SPALDING MI 49886

Officer/Director/Trustee Three

JESSICA JOHNSON
DIRECTOR; TREASURER
W3633 US HWY 2/41
SPALDING MI 49886

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/25/19
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T50 - Philanthropy, Charity, Voluntarism Promotion, General
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JESSICA JOHNSON
Signature Title DIRECTOR; TREASURER
Signature Date 8/12/19

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