FORM 1023-EZ for BROTHERS KEEPER MC A INC

Field Data
EIN 80-0845891
Case Number EO-2017102-000130
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BROTHERS KEEPER MC A INC
Organization’s Mailing Address POST OFFICE BOX 93
City ROPER
State NC
ZIP 27970
Accounting period End 7
Primary contact name STACIE M NOE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BOBBIE SIMPSON
PRESIDENT
1188 BACKWOODS ROAD
ROPER NC 27970

Officer/Director/Trustee Two

WILLIAM DOWNING
VICE PRESIDENT
PO BOX 457
PLYMOUTH NC 27962

Officer/Director/Trustee Three

WANDA GUION
SECRETARY
1697 MOUTH OF THE CREEK
BLOUNTS CREEK NC 27814

Officer/Director/Trustee Four

HATTIE BROWN
TREASURER
211 MARSHALL AVENUE
WILLIAMSTON NC 27892

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/7/2012
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W24 - Citizen Participation
Organization’s purpose Charitable: Yes
Religious: Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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