FORM 1023-EZ for INTER COMMUNITY ACTION NETWORK INC
| Field | Data |
|---|---|
| EIN | 47-4361052 |
| Case Number | EO-2021165-000373 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | INTER COMMUNITY ACTION NETWORK INC |
| Organization’s Mailing Address | 1005 MIDWAY SCHOOL ROAD |
| City | WINSTON-SALEM |
| State | NC |
| ZIP | 27107 |
| Accounting period End | 12 |
| Primary contact name | KELLY LEAK |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
KELLY LEAK
PRESIDENT
653 TERRACE DRIVE
LEXINGTON NC 27295
Officer/Director/Trustee Two
BRYAN CHENEY
TREASURER
298 SUMMIT STREET
RURAL HALL NC 27045
Officer/Director/Trustee Three
LARRY ROSEBORO
SECRETARY
422 THOMAS SCHOOL ROAD
WINSTON SALEM NC 27107
Officer/Director/Trustee Four
ANTONIO LINDSAY
DIRECTOR
173 TUTTLE ROAD
LEXINGTON NC 27295
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 6/13/2016 |
| Organization Incorporation State | NC |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | Z99 - Unclassified |
| Organization’s purpose | Charitable: Yes Religious: Yes Educational: Yes Scientific: No Literary: Yes Public Safety: No Amateur Sports: No Cruelty Prevention: Yes |
| 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 | KELLY LEAK |
| Signature Title | PRESIDENT |
| Signature Date | 6/11/2021 |
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