FORM 1023-EZ for SPECIAL CHIRO CARE INC

Field Data
EIN 81-4568083
Case Number EO-2016347-000204
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SPECIAL CHIRO CARE INC
Organization’s Mailing Address 3195 LAMAR AVENUE
City PARIS
State TX
ZIP 75460-5019
Accounting period End 12
Primary contact name TIFFANY BRISCOE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JASON HILL
DIRECTOR AND PRESIDENT
303 COUNTY ROAD 3640
SULPHUR SPRINGS TX 75482-6912

Officer/Director/Trustee Two

TIFFANY BRISCOE
DIRECTOR AND SECRETARY
6390 LAKEVIEW DRIVE
RENO TX 75462-6427

Officer/Director/Trustee Three

LORI HILL
TREASURER
303 COUNTY ROAD 3640
SULPHUR SPRINGS TX 75482-6912

Officer/Director/Trustee Four

KAITLYN SCANTLEN
DIRECTOR
5173 TEXAS HIGHWAY 154 S
SULPHUR SPRINGS TX 75482-8226

Organization’s website NONE
Organization’s email SPECIALCHIROCARE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/10/2016
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E30 - Health Treatment Facilities, Primarily Outpatient
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 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 Yes
One Third Support Gifts No
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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