FORM 1023-EZ for SUZETTE GROOMS ALS AWARENESS CORPORATION

Field Data
EIN 82-4319279
Case Number EO-2018040-000199
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SUZETTE GROOMS ALS AWARENESS CORPORATION
Organization’s Mailing Address 2922 NORTH RIDGE COURT
City LINCOLNTON
State NC
ZIP 28092
Accounting period End 6
Primary contact name NATHAN REID GROOMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NATHAN GROOMS
PRESIDENT
2922 NORTH RIDGE COURT
LINCOLNTON NC 28092

Officer/Director/Trustee Two

AMBER MINCEY
DIRECTOR
1730 IVEY CHURCH ROAD
MAIDEN NC 28650

Officer/Director/Trustee Three

LORI GROOMS
DIRECTOR
2922 NORTH RIDGE COURT
LINCOLNTON NC 28092

Officer/Director/Trustee Four

AMBER GROOMS
DIRECTOR
206 ARBOR RUN DRIVE APT P
LINCOLNTON NC 28092

Officer/Director/Trustee Five

DIANE REEL
DIRECTOR
893 NORTH INGLESIDE FARM ROAD
IRON STATION NC 28080

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/13/17
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G50 - Nerve, Muscle and Bone Diseases
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 NATHAN GROOMS
Signature Title PRESIDENT
Signature Date 2/7/18

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