FORM 1023-EZ for BETHEA AND DUBLIN FAMILY FOUNDATIONINC

Field Data
EIN 85-2394819
Case Number EO-2020275-000066
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BETHEA AND DUBLIN FAMILY FOUNDATIONINC
Organization’s Mailing Address 1914 ROSEMONT DRIVE APT 15
City GREENVILLE
State NC
ZIP 27858
Accounting period End 12
Primary contact name TRAVIS DUBLIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TRAVIS DUBLIN
DIR/PRES/TREAS/SECT
1914 ROSEMONT DRIVE APT 15
GREENVILLE NC 27858

Officer/Director/Trustee Two

DIANDRE DUBLIN
DIRECTOR
6046 JENNA LANE
KENLY NC 27542

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/31/2020
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T30 - Public Foundations
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 Yes
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 TRAVIS DUBLIN
Signature Title DIR/PRES/TREAS/SECT
Signature Date 9/29/2020

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