FORM 1023-EZ for VIRGINIA JAYNE AND MARY PAULINE VALTMAN CANCER CENTER

Field Data
EIN 83-1656630
Case Number EO-2018292-000311
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name VIRGINIA JAYNE AND MARY PAULINE VALTMAN CANCER CENTER
Organization’s Mailing Address 4913 BRIDGES STREET EXT BLDG B
City MOREHEAD CITY
State NC
ZIP 28557
Accounting period End 12
Primary contact name JAYME LIMBAUGH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAYME LIMBAUGH
PRESIDENT
111 SUNBURST CIRCLE
CEDAR POINT NC 28584

Officer/Director/Trustee Two

NORMA SKINNER
TREASURER
407 35TH STREET
MOREHEAD CITY NC 28557

Officer/Director/Trustee Three

DANIEL REITZ
CHAIRMAN
1601 SHEPARD STREET
MOREHEAD CITY NC 28557

Officer/Director/Trustee Four

PAULINE JUHLE
SECRETARY
308 N 7TH STREET
MOREHEAD CITY NC 28557

Officer/Director/Trustee Five

MAUREEN YOUNG
DIRECTOR
276 OAKLEAF DRIVE
PINE KNOLL SHORES NC 28512

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/14/18
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E60 - Health Support Services
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 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 JAYME LIMBAUGH
Signature Title PRESIDENT
Signature Date 10/17/18

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