FORM 1023-EZ for CAMDEN SERENITY CLUB INC

Field Data
EIN 58-1951154
Case Number EO-2015278-000417
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CAMDEN SERENITY CLUB INC
Organization’s Mailing Address 313 CENTRAL AVE
City KINGSLAND
State GA
ZIP 31548
Accounting period End 9
Primary contact name JANET DUFFIELD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

STEVE MUDGE
PRESIDENT
603 W CONYERS
ST. MARYS GA 31558

Officer/Director/Trustee Two

DAN UDY
VICE PRESIDENT
987 BAMBI DRIVE
ST. MARYS GA 31558

Officer/Director/Trustee Three

SUNI TAYLOR
TREASURER
188 WEST WOODHAVEN
KINGSLAND GA 31548

Officer/Director/Trustee Four

JANET DUFFIELD
SECRETARY
92 BECK
WOODBINE GA 31569

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/28/1981
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F20 - Alcohol, Drug and Substance Abuse, Dependency Prevention and Treatment
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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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