FORM 1023-EZ for THE IMPACT CENTER

Field Data
EIN 61-1533617
Case Number EO-2015208-000458
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE IMPACT CENTER
Organization’s Mailing Address 820 NASHVILLE ROAD
City ROCKY MOUNT
State NC
ZIP 27803-9303
Accounting period End 12
Primary contact name JAMES GAILLIARD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JAMES GAILLIARD
CHAIRMAN PRESIDENT
9121 WEST MOUNT DRIVE
ROCKY MOUNT NC 27803-9303

Officer/Director/Trustee Two

ANGELA BURTON
TREASURER
125 VINEYARD COURT
ROCKY MOUNT NC 27803-9303

Officer/Director/Trustee Three

RICHARD JOYNER
VICE PRESIDENT
2110 NORTH VILLAGE DRIVE
GREENVILLE NC 27834-9800

Officer/Director/Trustee Four

BELINDA WHITAKER
SECRETARY
1737 SPARROW HAWK LANE
ROCKY MOUNT NC 27804-9622

Officer/Director/Trustee Five

GWENDOLYN BARNES
MEMBER
4172 MEADOWVIEW LANE
ROCKY MOUNT NC 27804-9622

Organization’s website
Organization’s email PASTOR@WORDTAB.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/7/2007
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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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