FORM 1023-EZ for COMMUNITY HEALTHSOURCE
| Field | Data |
|---|---|
| EIN | 47-2339466 |
| Case Number | EO-2014328-000305 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | COMMUNITY HEALTHSOURCE |
| Organization’s Mailing Address | 4710 AUTH PLACE SUITE 510 |
| City | SUITLAND |
| State | MD |
| ZIP | 20746 |
| Accounting period End | 12 |
| Primary contact name | DAVID JACKSON |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $400.00 |
Officer/Director/Trustee One
DAVID JACKSON
CEO/PRESIDENT
7312 RIVERHILL RD
OXON HILL MD 20745
Officer/Director/Trustee Two
TONYA JACKSON
COO/SECRETARY
7312 RIVERHILL RD
OXON HILL MD 20745
Officer/Director/Trustee Three
SARA JOHNSON
BOARD OF DIRECTORS
101 MILAM COURT
BURGAW NC 28425
Officer/Director/Trustee Four
CHERYL WILSON
BOARD OF DIRECTORS
9051 HIGHWAY 11
WILLARD NC 28478
Officer/Director/Trustee Five
KYA MATHEWS
BOARD OF DIRECTORS
7812 COLONIAL LANE
CLINTON MD 20735
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 11/18/2014 |
| Organization Incorporation State | MD |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | E86 - Patient Services - Entertainment, Recreation |
| Organization’s purpose | Charitable: Yes Religious: No Educational: Yes Scientific: No Literary: Yes 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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