FORM 1023-EZ for PINE HILL CEMETARY ASSOCIATION

Field Data
EIN 30-1178611
Case Number EO-2019116-000200
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PINE HILL CEMETARY ASSOCIATION
Organization’s Mailing Address 236 GRAHAM DAVIS RD
City DENTON
State NC
ZIP 27239
Accounting period End 6
Primary contact name SCOTT DAVIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SCOTT DAVIS
PRESIDENT
236 GRAHAM DAVIS RD
DENTON NC 27239

Officer/Director/Trustee Two

BILL COOK
VICE -PRESIDENT
529 LINDSEY AVENUE
ASHEBORO NC 27203

Officer/Director/Trustee Three

HOLLY WHITE
SECRETARY
920 CLIFF ROAD
ASHEBORO NC 27203

Officer/Director/Trustee Four

LINDA DAVIS
TREASURER
235 GRAHAM DAVIS RD
DENTON NC 27239

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/30/17
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: 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 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 SCOTT DAVIS
Signature Title PRESIDENT
Signature Date 4/24/19

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