FORM 1023-EZ for HOME HOSPICE OF GA FOUNDATION INC

Field Data
EIN 83-0642323
Case Number EO-2018145-000646
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HOME HOSPICE OF GA FOUNDATION INC
Organization’s Mailing Address 2829 PEBBLE HILL POINTE
City DULUTH
State GA
ZIP 30096
Accounting period End 12
Primary contact name RAJESH PATEL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RAJESH PATEL
DIRECTOR
2829 PEBBLE HILL POINTE
DULUTH GA 30096

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/23/18
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
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 RAJESH PATEL
Signature Title DIRECTOR
Signature Date 5/23/18

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