FORM 1023-EZ for PRINCE GEORGES SENIOR PROVIDER NETWORK
| Field | Data |
|---|---|
| EIN | 27-2532496 |
| Case Number | EO-2021148-000104 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | PRINCE GEORGES SENIOR PROVIDER NETWORK |
| Organization’s Mailing Address | 9701 APOLLO DRIVE SUITE 297 |
| City | LARGO |
| State | MD |
| ZIP | 20774 |
| Accounting period End | 12 |
| Primary contact name | SHAUNDA BELLAMY |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
JENNIFER TILGMAN
PRESIDENT
9701 APOLLO DRIVE SUITE 297
LARGO MD 20774
Officer/Director/Trustee Two
VIKKI KALITSI
PAST PRESIDENT FOUNDER
9701 APOLLO DRIVE SUITE 297
LARGO MD 20774
Officer/Director/Trustee Three
SHAUNDA BELLAMY
TREASURER
9701 APOLLO DRIVE SUITE 297
LARGO MD 20774
Officer/Director/Trustee Four
KAREN SYLVESTER
VICE PRESIDENT
9701 APOLLO DRIVE SUITE 297
LARGO MD 20774
Officer/Director/Trustee Five
CARY HITHON
MEMBER AT LARGE
9701 APOLLO DRIVE SUITE 297
LARGO MD 20774
| Organization’s website | WWW.PGSPN.ORG |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 1/11/2012 |
| Organization Incorporation State | MD |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | P99 - Human Services - Multipurpose and Other N.E.C. |
| 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 | Yes |
| 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 | Yes |
| Correctness Declaration | Yes |
| Signature Name | SHAUNDA BELLAMY |
| Signature Title | TREASURER |
| Signature Date | 5/20/2021 |
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