FORM 1023-EZ for PARK OUTREACH

Field Data
EIN 83-4130940
Case Number EO-2019128-000138
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PARK OUTREACH
Organization’s Mailing Address 1353 RIVERSTONE PARKWAY SUITE 120
City CANTON
State GA
ZIP 30114
Accounting period End 12
Primary contact name CHUCK HELLIER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LEIGH HELLIER
PRESIDENT
201 FOUNTAIN OAK WAY
CANTON GA 30114

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/26/19
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X21 - Protestant
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 LEIGH HELLIER
Signature Title PRESIDENT
Signature Date 5/6/19

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