FORM 1023-EZ for SERENITY FALLS ADULT DAY CARE INC

Field Data
EIN 81-0874439
Case Number EO-2015362-000245
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SERENITY FALLS ADULT DAY CARE INC
Organization’s Mailing Address 13108 GRANTHAM RIDGE COURT
City ROSHARON
State TX
ZIP 77583
Accounting period End 12
Primary contact name DESHUN STANLEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DESHUN STANLEY
PRFESIDENT
13108 GRANTHAM RIDGE COURT
ROSHARON TX 77583

Officer/Director/Trustee Two

JEANETTE HATCHET
SECRETARY
13108 GRANTHAM RIDGE COURT
ROSHARON TX 77583

Officer/Director/Trustee Three

KIMBERLY WHITE
TREASURER
13108 GRANTHAM RIDGE COURT
ROSHARON TN 77583

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/16/2015
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P71 - Adult Daycare
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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 Yes
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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