FORM 1023-EZ for VETERAN RETREATS

Field Data
EIN 47-5048804
Case Number EO-2015350-000164
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name VETERAN RETREATS
Organization’s Mailing Address 7413 SIX FORKS RD
City RALEIGH
State NC
ZIP 27615
Accounting period End 12
Primary contact name FOSTORIA PIERSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KERRY WILLIAMS
DIRECTOR
7413 SIX FORKS RD
RALEIGH NC 27616

Officer/Director/Trustee Two

KEVIN JANEY
DIRECTOR
7413 SIX FORKS RD
RALEIGH NC 27615

Officer/Director/Trustee Three

ADRIAN HAMRICK
DIRECTOR
7413 SIX FORKS RD
RALEIGH NC 27615

Officer/Director/Trustee Four

HENAH HANNAH
DIRECTOR
7413 SIX FORKS RD
RALEIGH NC 27615

Officer/Director/Trustee Five

ROBERT WILCOX
DIRECTOR
7413 SIX FORKS RD
RALEIGH NC 27615

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/8/2015
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F30 - Mental Health Treatment - Multipurpose and N.E.C.
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 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
Signature Title
Signature Date

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