FORM 1023-EZ for PREMIER COMMUNITY CARE HOME INC

Field Data
EIN 87-1259446
Case Number EO-2021228-000572
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PREMIER COMMUNITY CARE HOME INC
Organization’s Mailing Address P0 BOX 90037
City COLUMBIA
State SC
ZIP 29204
Accounting period End 12
Primary contact name RONNI BRYANT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RONNI BRYANT
PRESIDENT
599 DUCKY BYRD TRAIL
EASTOVER SC 29044

Officer/Director/Trustee Two

JOSEPH NATHAN
SECRETARY
134 SHOREDITCH DRIVE
COLUMBIA SC 29209

Officer/Director/Trustee Three

SHAMEKA ROSS
VICE PRESIDENT
145 NATHAN RIDGE LANE
GADSDEN SC 29229

Officer/Director/Trustee Four

RONALD DAVIS
TREASURER
110 FALLEN OAK DRIVE
COLUMBIA SC 29290

Organization’s website
Organization’s email PCCHLLC@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/17/2001
Organization Incorporation State SC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P73 - Group Home (Long Term)
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name RONNI BRYANT
Signature Title PRESIDENT
Signature Date 8/13/2021

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