FORM 1023-EZ for PHOENIX PLACE HARBOR INC

Field Data
EIN 82-3841283
Case Number EO-2019046-000460
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PHOENIX PLACE HARBOR INC
Organization’s Mailing Address PO BOX 4153
City SANFORD
State NC
ZIP 27331
Accounting period End 12
Primary contact name SAMANTHA ROBINSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SAMANTHA ROBINSON
BOARD PRESIDENT AND CHAIR
314 PROVIDENCE HALL DRIVE
SANFORD NC 27330

Officer/Director/Trustee Two

BRENDA FENTON
SECRETARY
652 DENNING ROAD
ANGIER NC 27501

Officer/Director/Trustee Three

ALISA WATSON
BOARD OF DIRECTOR
9017 TURNER ROAD
HOLLY SPRINGS NC 27539

Officer/Director/Trustee Four

JAMES THORPE
BOARD OF DIRECTOR
348 BAYLEIGH CT
GARNER NC 27529

Officer/Director/Trustee Five

SAMANTHA JOHNSON
BOARD OF DIRECTOR
314 QUARTERMASTER ROAD
SANFORD NC 27330

Organization’s website
Organization’s email PHOENIXPLACE.RISE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/2/18
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Z99 - Unclassified
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
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 SAMANTHA ROBINSON
Signature Title BOARD PRESIDENT AND CHAIR
Signature Date 2/13/19

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