FORM 1023-EZ for FOREVER CAROLINA

Field Data
EIN 86-1661220
Case Number EO-2021082-000839
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FOREVER CAROLINA
Organization’s Mailing Address 7617 N 67TH AVENUE SUITE 201
City GLENDALE
State AZ
ZIP 85301
Accounting period End 12
Primary contact name REBECCA MAVILLE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

REBECCA MAVILLE
PRESIDENT
7617 N 67TH AVENUE SUITE 201
GLENDALE AZ 85301

Officer/Director/Trustee Two

MICHAEL HERNANDEZ
DIRECTOR
7617 N 67TH AVENUE SUITE 201
GLENDALE AZ 85301

Officer/Director/Trustee Three

HYDEIA NEWMAN
DIRECTOR
7617 N 67TH AVENUE SUITE 201
GLENDALE AZ 85301

Organization’s website
Organization’s email forevercarolinaaz@gmail.com
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/25/2021
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E92 - Home Health Care
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 REBECCA MAVILLE
Signature Title PRESIDENT
Signature Date 1/31/2021

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