FORM 1023-EZ for YOUR COMMUNITY AT WORK INC

Field Data
EIN 46-3767210
Case Number EO-2015243-000206
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name YOUR COMMUNITY AT WORK INC
Organization’s Mailing Address 158 NUNNALY ST
City RUTLEDGE
State GA
ZIP 30663
Accounting period End 12
Primary contact name JEROME ANDERSON JR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JEROME ANDERSON JR
PREDIENT
158 NUNNALY ST
RUTLEDGE GA 30663

Officer/Director/Trustee Two

QUALLIS JONES
VICE PRESIDENT
1141 HAYES ST
MADISON GA 30650

Officer/Director/Trustee Three

JEROME ANDERSON SR
SEC/TREAS
1577 BETHANY ROAD
MADISON GA 30650

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/2014
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W70 - Leadership Development
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 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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