FORM 1023-EZ for CAERUS ATHENS

Field Data
EIN 82-1056098
Case Number EO-2017227-000120
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CAERUS ATHENS
Organization’s Mailing Address 415 BAXTER STREET
City ATHENS
State GA
ZIP 30602
Accounting period End 4
Primary contact name WILLIAM VERINGA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

AAKASH MALHOTRA
CEO
325 WILLOW STREET
ATHENS GA 30601

Officer/Director/Trustee Two

WILLIAM VERINGA
CFO
205 SKYLAND DRIVE
ROSWELL GA 30075

Officer/Director/Trustee Three

FERNANDO CRUZ
SECRETARY
1705 REYNOLDS MILL DRIVE
LAWRENCEVILLE GA 30043

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/21/2016
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S43 - Management Services for Small Business, Entrepreneurs
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 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 Yes
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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