FORM 1023-EZ for LOUETTA ROBERTS HEMBY BREAST CANCERFOUNDATION

Field Data
EIN 83-1509490
Case Number EO-2019059-000515
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LOUETTA ROBERTS HEMBY BREAST CANCERFOUNDATION
Organization’s Mailing Address 126 WEST LENOIR AVENUE
City KINSTON
State NC
ZIP 28501
Accounting period End 12
Primary contact name KIMBERLY CAMPBELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LEKEISHA FIELDS
FOUNDER
700 EAGLE ROAD
KINSTON NC 28501

Officer/Director/Trustee Two

KIMBERLY CAMPBELL
CHIEF FUNDRAISING OFFICER
5605 SLIDE ROCK LANE
RALEIGH NC 27613-1058

Organization’s website WWW.LRHBREASTCANCERFOUNDATION.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/31/18
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B12 - Fund Raising and/or Fund Distribution
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 Yes
Conducting Activities Outside of United States No
Financial transactions with officers Yes
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name LEKEISHA FIELDS
Signature Title FOUNDER
Signature Date 2/26/19

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