FORM 1023-EZ for FOUNDATION FOR COMMUNITY IMPACT & HEALTH EQUITY

Field Data
EIN 85-0515175
Case Number EO-2020090-000074
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FOUNDATION FOR COMMUNITY IMPACT & HEALTH EQUITY
Organization’s Mailing Address 657 SYRUP MILL RD
City RIDGEWAY
State SC
ZIP 29130
Accounting period End 12
Primary contact name QUINTASHA KNOX
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

QUINTASHA KNOX
CEO
657 SYRUP MILL RD
RIDGEWAY SC 29130

Officer/Director/Trustee Two

BELINDA BUTLER
CHAIR
6 CANE BREAK CT
COLUMBIA SC 29229

Officer/Director/Trustee Three

CHERYL YOUNG-GOODWIN
VICE-CHAIR
1289 SYRUP MILL RD
RIDGEWAY SC 29130

Officer/Director/Trustee Four

DEMETRIUS CUMMINGS JR
TREASURER
4 BENTREE LN
CAMDEN SC 29020

Officer/Director/Trustee Five

KANETRIA ROBINSON
SECRETARY
557 STRATHCLYDE WAY
ROCK HILL SC 29730

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/25/2020
Organization Incorporation State SC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion 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 Yes
Compensation of Officer director trustee Yes
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 QUINTASHA KNOX
Signature Title CEO
Signature Date 3/26/2020

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