FORM 1023-EZ for CLAYTON FARM AND COMMUNITY MARKET INC

Field Data
EIN 84-3453810
Case Number EO-2019298-000200
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CLAYTON FARM AND COMMUNITY MARKET INC
Organization’s Mailing Address PO BOX 1452
City CLAYTON
State NC
ZIP 27528
Accounting period End 12
Primary contact name RACHEL E MILLS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANDRIA MERRITT
PRESIDENT
406 SOUTH FAYETTEVILLE ST
CLAYTON NC 27520

Officer/Director/Trustee Two

ROBIN ENDRESS
VICE PRESIDENT
137 REDBUD DR
CLAYTON NC 27520

Officer/Director/Trustee Three

GERRY MORGAN
SECRETARY
19 SEAHORSE CT
BENSON NC 27504

Officer/Director/Trustee Four

KATHY BENNEK
TREASURER
300 PINE TREE RD
SELMA NC 27576

Officer/Director/Trustee Five

ROBBIE CARVER
DIRECTOR
23 MARY ELLEN WAY
CLAYTON NC 27520

Organization’s website CFCMNC.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/16/19
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
Organization’s purpose Charitable: Yes
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 ANDRIA MERRITT
Signature Title PRESIDENT
Signature Date 10/23/19

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