FORM 1023-EZ for GENESIS PROJECT FAMILY WELLNESS CENTER INC

Field Data
EIN 32-0210454
Case Number EO-2018089-000270
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GENESIS PROJECT FAMILY WELLNESS CENTER INC
Organization’s Mailing Address 5104 REAGAN DR 5
City CHARLOTTE
State NC
ZIP 28206
Accounting period End 12
Primary contact name JR BLACK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DONNA MCKOY
PRESIDENT
1713 BLANDFORD DR
CHARLOTTE NC 28206

Officer/Director/Trustee Two

DARRYL FROST
VICE PRESIDENT
935 JOHNSTON AND WALES WAY
CHARLOTTE NC 28202

Officer/Director/Trustee Three

MELANIE PARKER
SECRETARY
317 MCGINN GROVE DR
CHARLOTTE NC 28216

Officer/Director/Trustee Four

SUSAN FURR
DIRECTOR
9201 UUNIVERSITY CITY BLVD
CHARLOTTE NC 28223

Officer/Director/Trustee Five

CYNTHIA WILLIAMS
DIRECTOR
BOX 667814
CHARLOTTE NC 28266

Organization’s website WWW.GENESISPROJECT1.COM
Organization’s email INFO@GENESISPROJECT1.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/15/07
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
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 Yes
Correctness Declaration Yes
Signature Name DONNA MCKOY
Signature Title PRESIDENT
Signature Date 3/28/18

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