FORM 1023-EZ for KAREN DALE FOUNDATION

Field Data
EIN 83-1425926
Case Number EO-2018233-000234
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KAREN DALE FOUNDATION
Organization’s Mailing Address 8237 EARLY BIRD WAY
City MINT HILL
State NC
ZIP 28227-3740
Accounting period End 6
Primary contact name NARCISSE MONDESIR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ALLISON BURKETT
PRESIDENT, BOARD CHAIRPERSON
8237 EARLY BIRD WAY
MINT HILL NC 28227-3740

Officer/Director/Trustee Two

NARCISSE MONDESIR
TREASURER, DIRECTOR
3004 SHADOWY RETREAT DRIVE
MATTHEWS NC 28104

Officer/Director/Trustee Three

LORENA PRINCE
SECRETARY, DIRECTOR
123 MARGARET TURNER ROAD
CHARLOTTE NC 28216

Officer/Director/Trustee Four

URICA BAKER-CRON
DIRECTOR
1504 HIDEAWAY PLACE
SILVER SPRING MD 20906

Officer/Director/Trustee Five

ANDREA FORD
DIRECTOR
11405 TRETON COURT
UPPER MARLBORO MD 20774

Organization’s website
Organization’s email KARENDALEFOUNDATION@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/1/18
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T30 - Public Foundations
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 Yes
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 ALLISON BURKETT
Signature Title PRESIDENT, BOARD CHAIRPERSON
Signature Date 8/19/18

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