FORM 1023-EZ for STILL WATERS ADULT DAY FACILITY

Field Data
EIN 83-3449112
Case Number EO-2019072-000556
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name STILL WATERS ADULT DAY FACILITY
Organization’s Mailing Address 700 BRANTLEY STREET
City OPP
State AL
ZIP 36467
Accounting period End 12
Primary contact name JEANETTE WATERS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JEANETTE WATERS
PRESIDENT
302 OVERHILL RD
OPP AL 36467

Officer/Director/Trustee Two

JULIE GREEN
TREASURE
705 PATTERSON DRIVE
OPP AL 36467

Officer/Director/Trustee Three

HAYLEE HARRIS
SECRETARY
1807 CO RD 546
NEW BROCKTON AL 36351

Officer/Director/Trustee Four

GARY WATERS
VICE PRESIDENT
75 CO RD
SAMSON AL 36477

Organization’s website HTTP://OPP-ADULT-DAY-FACILITY.WEBNODE.COM/
Organization’s email STILLWATERSADULTDAYFACILITY@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/22/19
Organization Incorporation State AL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P82 - Developmentally Disabled Centers, 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 Yes
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers Yes
Unrelated Gross Income $1,000 or More Yes
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 JEANETTE WATERS
Signature Title PRESIDENT
Signature Date 3/11/19

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