FORM 1023-EZ for QTIPOC FOREVER HOME INC

Field Data
EIN 85-3332808
Case Number EO-2020296-000797
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name QTIPOC FOREVER HOME INC
Organization’s Mailing Address 1110 OLD SCHOOL RD
City CHAPEL HILL
State NC
ZIP 27516
Accounting period End 12
Primary contact name SHARON HOLLAND
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHARON HOLLAND
BOARD CHAIR
1110 OLD SCHOOL RD
CHAPEL HILL NC 27516-0529

Officer/Director/Trustee Two

TIZ GIORDANO
SECRETARY
310 LINDSAY STREET
CHAPEL HILL NC 27516-2127

Officer/Director/Trustee Three

DOLORES CHANDLER
TREASURER
1611 HOMEWOOD AVENUE
DURHAM NC 27707-4936

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/30/2020
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P88 - LGBTQ Centers
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 SHARON HOLLAND
Signature Title BOARD CHAIR
Signature Date 10/19/2020

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