FORM 1023-EZ for TRIAD REGIONAL PAYEE SERVICES INC

Field Data
EIN 82-4071589
Case Number EO-2018095-000724
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TRIAD REGIONAL PAYEE SERVICES INC
Organization’s Mailing Address 1243 EAST SPRAGUE STREET
City WINSTON SALEM
State NC
ZIP 27107-2511
Accounting period End 12
Primary contact name SHIELA MARSHALL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHEILA MITCHELL
PRESIDENT
2219 GLENSIDE DRIVE
GREENSBORO NC 27405-1613

Officer/Director/Trustee Two

BELEITA MACK
TREASURER
1627 FAIRVIEW BLVD
WINSTON SALEM NC 27127-2014

Officer/Director/Trustee Three

TERRI MARTIN
SECRETARY
3000 CORRY CIRCLE
WINSTON SALEM NC 27107-2511

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/12/18
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P80 - Services to Promote the Independence of Specific Populations
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 SHEILA MITCHELL
Signature Title PRESIDENT
Signature Date 3/24/18

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