FORM 1023-EZ for FAITH ADULT DAY CARE CORP

Field Data
EIN 86-3064300
Case Number EO-2021172-000041
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FAITH ADULT DAY CARE CORP
Organization’s Mailing Address 7203 E STATE HIGHWAY 3
City IDABEL
State OK
ZIP 74745
Accounting period End 12
Primary contact name AMI PARKER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

AMI PARKER
INCPTR & PRES & DIR
7203 E STATE HIGHWAY 3
IDABEL OK 74745

Officer/Director/Trustee Two

KAYSEE THAMES
TRES & SECT & DIR
2055 RODEO ROAD
BROKEN BOW OK 74728

Officer/Director/Trustee Three

AMANDA FIELDER
DIRECTOR
1106 SEAGULL LANE
IDABEL OK 74745

Organization’s website
Organization’s email FAITHADC2020@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/29/2021
Organization Incorporation State OK
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P71 - Adult Daycare
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 Yes
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 AMI PARKER
Signature Title INCPTR & PRES & DIR
Signature Date 6/16/2021

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