FORM 1023-EZ for DIABETES YOU CAN WIN FOUNDATION INCOPORATION

Field Data
EIN 81-4881677
Case Number EO-2017033-000207
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DIABETES YOU CAN WIN FOUNDATION INCOPORATION
Organization’s Mailing Address 1847 PRESERVE CREEK WAY
City LOGANVILLE
State GA
ZIP 30052
Accounting period End 12
Primary contact name LISA GRAHAM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LISA GRAHAM
CEO
1847 PRESERVE CREEK WAY
LOGANVILLE GA 30052

Officer/Director/Trustee Two

DARLENE CLARK
CFO
2360 IVEY OAKS PLACE
STONE MOUNTAIN GA 30087

Officer/Director/Trustee Three

JAN GRAHAM
SECRETARY
1847 PRESERVE CREEK WAY
LOGANVILLE GA 30052

Officer/Director/Trustee Four

TODD TYLER
BOARD OF DIRECTORS
7036 BREKEN TRACE
LITHONIA GA 30058

Organization’s website DIABETESYOUCANWIN.ORG
Organization’s email LISAGRAHAM@DIABETESYOUCANWIN.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/23/2016
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 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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