FORM 1023-EZ for THE MIA BELLA FOUNDATION

Field Data
EIN 85-4180304
Case Number EO-2021097-000174
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE MIA BELLA FOUNDATION
Organization’s Mailing Address 3514 BELRIDGE LANE SE
City SMYRNA
State GA
ZIP 30080
Accounting period End 12
Primary contact name THOMAS LACCETTI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

THOMAS LACCETTI
PRESIDENT & DIRECTOR
3514 BELRIDGE LANE SE
SMYRNA GA 30080

Officer/Director/Trustee Two

ANN MUZIO
TREASURER & DIRECTOR
501 CYPRESS LINKS WAY
TAYLORS SC 29687

Officer/Director/Trustee Three

AMANDA CARNEY
SECRETARY & DIRECTOR
11568 JEFFERIES HWY LOT 14
WALTERBORO SC 29488

Organization’s website
Organization’s email TOM@ATLARCHITECTS.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/1/2020
Organization Incorporation State SC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F53 - Eating Disorder, Addiction
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 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 THOMAS LACCETTI
Signature Title PRESIDENT & DIRECTOR
Signature Date 3/11/2021

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