FORM 1023-EZ for ROSENWALD AT COTTON CREEK CENTER

Field Data
EIN 46-3305721
Case Number EO-2015209-000100
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ROSENWALD AT COTTON CREEK CENTER
Organization’s Mailing Address PO BOX998
City SOUTH HILL
State VA
ZIP 23970
Accounting period End 12
Primary contact name JACYNTHIA RUSSELL SWAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ELMO ALEXANDER
PRESIDENT
60 PINEVIEW CT
FAIRFIELD OH 45104

Officer/Director/Trustee Two

WALLACE EVANS
VICE PRESIDENT
1123 EAST ANDREWS AVENUE
HENDERSON NC 27516

Officer/Director/Trustee Three

HENERETTE JOHEN
SECRETARY
PO BOX 948
WAKE FOREST NC 27587

Officer/Director/Trustee Four

DOMINIE THOMPSON
TREASURER
6835 SPANDRIL LANE
CHARLOTTE NC 28215

Officer/Director/Trustee Five

SHARI SWANN
ASST. SECRETARY
8016 MCGUIRE DRIVE
RALEIGH NC 27616

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/31/2013
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N31 - Community Recreational Centers
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 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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