FORM 1023-EZ for PHOENIX GRACE INC

Field Data
EIN 83-4151164
Case Number EO-2019133-000273
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PHOENIX GRACE INC
Organization’s Mailing Address 141 GAINSWAY DRIVE
City NICHOLASVILLE
State KY
ZIP 40356
Accounting period End 12
Primary contact name ANN NIPP
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANN NIPP
PRESIDENT
141 GAINSWAY DRIVE
NICHOLASVILLE KY 40356

Officer/Director/Trustee Two

CHAD NIPP
TREASURER
141 GAINSWAY DRIVE
NICHOLASVILLE KY 40356

Officer/Director/Trustee Three

NANCY HILL
SECRETARY
701 RICHMOND AVE
NICHOLASVILLE KY 40356

Officer/Director/Trustee Four

JANA SEAMAN
DIRECTOR
757 BROAD CT S
NAPLES FL 34102

Officer/Director/Trustee Five

KRISTIE BURTON
DIRECTOR
230 SEXTON ROAD
HARRODSBURG KY 40330

Organization’s website WWW.PHOENIXGRACEKY.ORG
Organization’s email ANIPP@PHOENIXGRACEKY.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/27/19
Organization Incorporation State KY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G98 - Pediatrics
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 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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ANN NIPP
Signature Title PRESIDENT
Signature Date 5/9/19

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