FORM 1023-EZ for REFORM

Field Data
EIN 30-0518174
Case Number EO-2020210-000859
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name REFORM
Organization’s Mailing Address 617 B EAST BROAD AVE
City ROCKINGHAM
State NC
ZIP 28379
Accounting period End 12
Primary contact name KELLY HUTCHINSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KELLY HUTCHINSON
EXECUTIVE DIRECTOR/PRESIDENT
1018 SCALEYBARK RD
ROCKINGHAM NC 28379

Officer/Director/Trustee Two

KENDRICK HUTCHINSON
VICE PRESIDENT
609 WALNUT LANE
ROCKINGHAM NC 28379

Officer/Director/Trustee Three

KENTA HUTCHINSON
COMMITTEE CHAIR
1018 SCALEYBARK RD
ROCKINGHAM NC 28379

Officer/Director/Trustee Four

EBONY WASHINGTON
TREASURER
513 BRADFORD DRIVE
ABERDEEN NC 28315

Officer/Director/Trustee Five

PAULLETT WALL
SECRETARY
953 MONTCLAIRE AVENUE
ROCKINGHAM NC 28379

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/30/2017
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 KELLY HUTCHINSON
Signature Title EXECUTIVE DIRECTOR/PRESIDENT
Signature Date 7/26/2020

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