FORM 1023-EZ for HOLT STREET BAPTIST CHURCH HEALTH &HUMAN SERVICES CORPORATION

Field Data
EIN 83-4447177
Case Number EO-2019112-000433
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HOLT STREET BAPTIST CHURCH HEALTH &HUMAN SERVICES CORPORATION
Organization’s Mailing Address 1870 S COURT ST
City MONTGOMERY
State AL
ZIP 36104
Accounting period End 12
Primary contact name DR W D MCCLUNG
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

WILLIE D MCCLUNG
DIRECTOR
1870 S COURT ST
MONTGOMERY AL 36104

Officer/Director/Trustee Two

TONYA ALLEN
DIRECTOR
1870 S COURT ST
MONTGOMERY AL 36104

Officer/Director/Trustee Three

LOLITA L SHEPHERD
DIRECTOR
1870 S COURT ST
MONTGOMERY AL 36104

Officer/Director/Trustee Four

KEISHA GRAVES
DIRECTOR
1870 S COURT ST
MONTGOMERY AL 36104

Officer/Director/Trustee Five

THOMAS TURNER SR
DIRECTOR
1870 S COURT ST
MONTGOMERY AL 36104

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/8/19
Organization Incorporation State AL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: Yes
Literary: Yes
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 Yes
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 WILLIE D MCCLUNG
Signature Title DIRECTOR
Signature Date 4/18/19

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