FORM 1023-EZ for SMOOTH FLAVA WELLNESS AND FINE ARTS

Field Data
EIN 87-1695767
Case Number EO-2021200-000662
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SMOOTH FLAVA WELLNESS AND FINE ARTS
Organization’s Mailing Address 2661 PARKSIDE WAY
City SNELLVILLE
State GA
ZIP 30078
Accounting period End 12
Primary contact name LADELL HEADROE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LADELL HEADROE
EXECUTIVE DIRECTOR
2661 PARKSIDE WAY
SNELLVILLE GA 30078

Officer/Director/Trustee Two

SAMUEL ROBERSON
PRESIDENT
2661 PARKSIDE WAY
SNELLVILLE GA 30078

Officer/Director/Trustee Three

PAUL CASTLE
VICE PRESIDENT
2661 PARKSIDE WAY
SNELLVILLE GA 30078

Organization’s website
Organization’s email SMOOTHFLAVA@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/9/2021
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A60 - Performing Arts Organizations
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 Yes
Donation of funds Yes
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 LADELL HEADROE
Signature Title EXECUTIVE DIRECTOR
Signature Date 7/17/2021
EIN 87-1695767
Case Number EO-2021200-000662
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SMOOTH FLAVA WELLNESS AND FINE ARTS
Organization’s Mailing Address 2661 PARKSIDE WAY
City SNELLVILLE
State GA
ZIP 30078
Accounting period End 12
Primary contact name LADELL HEADROE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LADELL HEADROE
EXECUTIVE DIRECTOR
2661 PARKSIDE WAY
SNELLVILLE GA 30078

Officer/Director/Trustee Two

SAMUEL ROBERSON
PRESIDENT
2661 PARKSIDE WAY
SNELLVILLE GA 30078

Officer/Director/Trustee Three

PAUL CASTLE
VICE PRESIDENT
2661 PARKSIDE WAY
SNELLVILLE GA 30078

Organization’s website
Organization’s email SMOOTHFLAVA@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/9/2021
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A60 - Performing Arts Organizations
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 Yes
Donation of funds Yes
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 LADELL HEADROE
Signature Title EXECUTIVE DIRECTOR
Signature Date 7/17/2021

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