FORM 1023-EZ for CHOSEN MINISTRY DOMINICAN INC

Field Data
EIN 86-1333495
Case Number EO-2021056-000492
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CHOSEN MINISTRY DOMINICAN INC
Organization’s Mailing Address 234 STACY WEAVER DR
City FAYETTEVILLE
State NC
ZIP 28311
Accounting period End 12
Primary contact name SHALA LAMOTHE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHAD LINGERFELT
PRESIDENT
410 BERRY RD
TAYLORS SC 29687

Officer/Director/Trustee Two

SHALA LAMOTHE
TREASURER
8550 NW 17TH STR STE 110B SS-114512
DORAL FL 33126

Officer/Director/Trustee Three

DAVID HUGHES
DIRECTOR
8550 NW 17TH STR STE 110B SS-114512
DORAL FL 33126

Officer/Director/Trustee Four

DAVID HUFF
REGISTERED AGENT
234 STACY WEAVER DR
FAYETTEVILLE NC 28311

Officer/Director/Trustee Five

TAMMY LINGERFELT
BOARD MEMBER
410 BERRY RD
TAYLORS SC 29687

Organization’s website www.chosenministrydominic
Organization’s email drshala@chosenministrydr.org
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/31/2020
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X21 - Protestant
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 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 CHAD LINGERFELT
Signature Title PRESIDENT
Signature Date 1/8/2021

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