FORM 1023-EZ for COMMUNITY SENIOR ENHANCEMENT PROGRAM

Field Data
EIN 47-1114659
Case Number EO-2016258-000148
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name COMMUNITY SENIOR ENHANCEMENT PROGRAM
Organization’s Mailing Address PO BOX 38 8900 NC HWY 35
City SEVERN
State NC
ZIP 27877
Accounting period End 6
Primary contact name JOHN THOMAS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PHYLLIS MANLEY NEWSOME
INTERIM PROGRAM DIRECTOR
8900 NC HWY 35 N
SEVERN NC 27877

Officer/Director/Trustee Two

BETTY GOLDSBERRY
SECRETARY
589 WILLIS HARE RD
PENDLETON NC 27862

Officer/Director/Trustee Three

MARY A GRANGER
FINANCIAL TREASURER / BOOK KEEPING
PO BOX 112
CONWAY NC 27820

Officer/Director/Trustee Four

ELAINE HARRIS
NUTRITION / PURCHASING
121 E LEWISTON RD
MURFREESBORO NC 27855

Officer/Director/Trustee Five

MAUDIE TYLER
HOSPITALITY / HISTORIAN
2173 BRITTON RD
PENDLETON NC 27862

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/16/2014
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T31 - Community 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 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
Signature Title
Signature Date

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