FORM 1023-EZ for CAROLINAS HOUSE OF MERCY

Field Data
EIN 47-2824056
Case Number EO-2015364-000076
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CAROLINAS HOUSE OF MERCY
Organization’s Mailing Address PO BOX 38843
City CHARLOTTE
State NC
ZIP 28278
Accounting period End 12
Primary contact name ARSHIA MEHDI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SEEMA AZAD
PRESIDENT
11107 KEMPSFORD DRIVE
CHARLOTTE NC 28262

Officer/Director/Trustee Two

ASRA KHAN
VICE PRESIDENT
4220 PROSPERITY CHURCH ROAD
CHARLOTTE NC 28269

Officer/Director/Trustee Three

NAAZ BRELVI
TREASURER
6350 CUMBERLAND DRIVE
HARRISBURG NC 28075

Officer/Director/Trustee Four

ARSHIA MEHDI
SECRETARY
5004 RIM ROCK CT
CHARLOTTE NC 28278

Officer/Director/Trustee Five

ROMANA SHAMS
DIRECTOR
1829 PROGRESS LANE
CHARLOTTE NC 28205

Organization’s website CAROLINASHOUSEOFMERCY.ORG
Organization’s email CAROLINASHOUSEOFMERCY@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/15/2014
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P43 - Family Violence Shelters, Services
Organization’s purpose Charitable: Yes
Religious: Yes
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 Yes
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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