FORM 1023-EZ for MONROE COUNTY SPECIAL NEEDS CLUB INC

Field Data
EIN 45-5247416
Case Number EO-2017019-000344
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MONROE COUNTY SPECIAL NEEDS CLUB INC
Organization’s Mailing Address 44 E JOHNSTON ST
City FORSYTH
State GA
ZIP 31029
Accounting period End 12
Primary contact name MARTIE BROWN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GEORGE PIRKLE
CFO
1397 JULIETTE ROAD
FORSYTH GA 31029

Officer/Director/Trustee Two

LUANN MURPHY
SECRETARY
44 EAST JOHNSTON ST
FORSYTH GA 31029

Officer/Director/Trustee Three

MARTIE BROWN
CEO
44 EAST JOHNSTON ST
FORSYTH GA 31029

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/9/2012
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O99 - Youth Development 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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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