FORM 1023-EZ for GRASSROOTS COMMUNITY FOUNDATION

Field Data
EIN 87-2541657
Case Number EO-2021259-000334
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GRASSROOTS COMMUNITY FOUNDATION
Organization’s Mailing Address 237 MUSES MILL COURT
City HOLLY SPRINGS
State NC
ZIP 27540
Accounting period End 12
Primary contact name BRANDON MOORE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRANDON MOORE
DIRECTOR
237 MUSES MILL COURT
HOLLY SPRINGS NC 27540

Officer/Director/Trustee Two

BARB WHEELER
OFFICER
109 WANDERVIEW LANE
HOLLY SPRINGS NC 27540

Officer/Director/Trustee Three

TERRY ROUSE
OFFICER
932 FILBERT LANE
RALEIGH NC 27610

Organization’s website GRASSROOTS NC
Organization’s email GRASSROOTSBASKETBALLNC@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/2/2021
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
Public Safety: No
Amateur Sports: Yes
Cruelty Prevention: Yes
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 Yes
Gaming Activity No
Disaster relief assistance Yes
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 BRANDON MOORE
Signature Title DIRECTOR
Signature Date 9/14/2021

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