FORM 1023-EZ for WITHERS SWASH PARK MINISTRY

Field Data
EIN 47-3495821
Case Number EO-2015126-000167
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name WITHERS SWASH PARK MINISTRY
Organization’s Mailing Address 1551 21ST AVE N SUITE 15
City MYRTLE BEACH
State SC
ZIP 29577-7495
Accounting period End 12
Primary contact name CAROL STALLINGS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CAROL STALLINGS
PRESIDENT
683 RAMSEY DR
MYRTLE BEACH SC 29577-4331

Officer/Director/Trustee Two

WAYNE BROWN
VICE-PRESIDENT
PO BOX 70777
MYRTLE BEACH SC 29572-0031

Officer/Director/Trustee Three

PATTIE HOWER
SECRETARY/TREASURER
127 MARY ANN CT
MYRTLE BEACH SC 29579-7130

Officer/Director/Trustee Four

PAM WARNER
ASSISTANT SECRETARY
215 WACCAMAW VILLAGE DR
MYRTLE BEACH SC 29579-7504

Officer/Director/Trustee Five

CLARK PARKER
DIRECTOR
1551 21ST AVE N SUITE 15
MYRTLE BEACH SC 29577-7495

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/27/2015
Organization Incorporation State SC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P80 - Services to Promote the Independence of Specific Populations
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
Signature Title
Signature Date

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