FORM 1023-EZ for BROTHERS AND SISTERS OF THE PATCH INC

Field Data
EIN 84-3759240
Case Number EO-2020241-000062
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BROTHERS AND SISTERS OF THE PATCH INC
Organization’s Mailing Address 108 MIDIAN COURT
City WINSTON-SALEM
State NC
ZIP 27105
Accounting period End 12
Primary contact name FAYE HAIRSTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DONALD DICKERSON
PRESIDENT/CHAIRMAN
1200 N GRANT DRIVE
SHERMAN TX 75092

Officer/Director/Trustee Two

FAYE HAIRSTON
VICE PRESIDENT/DIRECTOR
108 MIDIAN COURT
WINSTON-SALEM NC 27105

Officer/Director/Trustee Three

TASHINA LONDON
TREASURER/DIRECTOR
4339 WOODALL DRIVE
CHARLESTON WV 25313

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/26/2020
Organization Incorporation State WV
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
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 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 FAYE HAIRSTON
Signature Title VICE PRESIDENT/DIRECTOR
Signature Date 8/26/2020

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