FORM 1023-EZ for A BEAUTIFUL DOMINO AFFECT CORPORATION

Field Data
EIN 84-4474010
Case Number EO-2020142-000352
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name A BEAUTIFUL DOMINO AFFECT CORPORATION
Organization’s Mailing Address 3816 SHENFIELD DRIVE
City UNION
State GA
ZIP 30291
Accounting period End 12
Primary contact name DENISE BROOKS-NUTT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DENISE BROOKS-NUTT
PRESIDENT
3816 SHENFIELD DRIVE
UNION GA 30291

Officer/Director/Trustee Two

SHANEQUIA TRAMMELL
TREASURER- DIRECTOR
3816 SHENFIELD DRIVE
UNION GA 30291

Officer/Director/Trustee Three

DERRICK HORTON
SECRETARY - CHAIRMAN
3816 SHENFIELD DRIVE
UNION GA 30291

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/23/2020
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
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 DENISE BROOKS-NUTT
Signature Title PRESIDENT
Signature Date 5/19/2020

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