FORM 1023-EZ for PROVIDOM
| Field | Data |
|---|---|
| EIN | 82-2494680 |
| Case Number | EO-2017263-000279 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | PROVIDOM |
| Organization’s Mailing Address | 10555 MONTGOMERY RD UNIT 30 |
| City | CINCINNATI |
| State | OH |
| ZIP | 45242 |
| Accounting period End | 12 |
| Primary contact name | CANDICE HAYES-MCINNIS |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
CANDICE HAYES-MCINNIS
PRESIDENT AND TREASURER
10555 MONTGOMERY RD UNIT 30
CINCINNATI OH 45242
Officer/Director/Trustee Two
DAVE MOORING
CHAIRPERSON
621 MCALPIN AVE
CINCINNATI OH 45220
Officer/Director/Trustee Three
FREDRICK PEGUES JR
EXECUTIVE BOARD MEMBER
3115 DERDEN RD UNIT E
GREENSBORO NC 27407
Officer/Director/Trustee Four
ANTHONY PERRY
EXECUTIVE BOARD MEMBER
6463 COYOTE CT
WEST CHESTER OH 45069
Officer/Director/Trustee Five
JAZMINE WILSON
ADVISORY COUNCIL BOARD MEMBER
11748 OLYMPIA WAY UNIT 211
CINCINNATI OH 45240
| Organization’s website | |
|---|---|
| Organization’s email | CANDICE3105@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 8/15/2017 |
| Organization Incorporation State | OH |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | P51 - Financial Counseling, Money Management |
| Organization’s purpose | Charitable: Yes Religious: No Educational: Yes 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 | 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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