FORM 1023-EZ for FOUR IV INC

Field Data
EIN 46-1014815
Case Number EO-2017254-000384
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FOUR IV INC
Organization’s Mailing Address 525 GRAY FOX CT
City LELAND
State NC
ZIP 28451-9552
Accounting period End 12
Primary contact name CT SHAW
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CT SHAW
PRESIDENT
525 GRAY FOX CT
LELAND NC 28451-9552

Officer/Director/Trustee Two

HOLLY SHAW
SECRETARY
525 GRAY FOX CT
LELAND NC 28451-9552

Officer/Director/Trustee Three

LYLE STEVENS
TREASURER
864 BROOKSMILL DR
TEGA CAY SC 29708

Officer/Director/Trustee Four

LEAKATHRYN HARLAN
TRUSTEE
3411 DURDEN DR 9102
ATLANTA GA 30319

Organization’s website WWW.FOUR-IV.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/26/2012
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T30 - Public Foundations
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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