FORM 1023-EZ for SOUTH CAROLINA MEN OF COLOR HEALTHALLIANCE

Field Data
EIN 85-1079669
Case Number EO-2020156-000164
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SOUTH CAROLINA MEN OF COLOR HEALTHALLIANCE
Organization’s Mailing Address 377 PIN OAK DR
City LEXINGTON
State SC
ZIP 29073
Accounting period End 12
Primary contact name KEITH ALLEN CAMPBELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KEITH CAMPBELL
PRESIDENT
377 PIN OAK DR
LEXINGTON SC 29073

Officer/Director/Trustee Two

DENISE SMITH
VICE PRESIDENT
18 BERRYHILL RD
COLUMBIA SC 29210

Officer/Director/Trustee Three

MAURICE ADAIR
TREASURER
811 PENDLETON ST
GREENVILLE SC 29601

Officer/Director/Trustee Four

GERALD MCNAIR
SECRETARY
1627 BRUNSWICK DR
COLUMBIA SC 29203

Organization’s website WWW.SCMSMWORKGROUP.ORG
Organization’s email MOCHA1SCMSM@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/21/2019
Organization Incorporation State SC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code R01 - Alliance/Advocacy Organizations
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name KEITH CAMPBELL
Signature Title PRESIDENT
Signature Date 6/2/2020

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