FORM 1023-EZ for COMMUNITY KIDNEY CARE

Field Data
EIN 82-3036069
Case Number EO-2017313-000174
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name COMMUNITY KIDNEY CARE
Organization’s Mailing Address 1833 EASTERN HILLS DRIVE
City GARLAND
State TX
ZIP 75043
Accounting period End 12
Primary contact name TIFFANY ARCHIBALD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TIFFANY ARCHIBALD
PRESIDENT/DIRECTOR
1833 EASTERN HILLS
GARLAND TX 75043

Officer/Director/Trustee Two

KAYWANDA LAMB
TREASURER/DIRECTOR
7951 COLLIN MCKINNEY PARKWAY 4039
MCKINNEY TX 75070

Officer/Director/Trustee Three

HEATHER DUNCAN
SECRETARY/DIRECTOR
401 NORTHWEST HIGHWAY 3206
IRVING TX 75039

Organization’s website COMMUNITYKIDNEYCARE.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/11/2017
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E60 - Health Support Services
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
Signature Title
Signature Date

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