FORM 1023-EZ for GEORGIA SMOKE DIVER FOUNDATION INC

Field Data
EIN 83-2827576
Case Number EO-2019030-000777
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GEORGIA SMOKE DIVER FOUNDATION INC
Organization’s Mailing Address PMB421 4880 LWR ROSWELL RD STE 165
City MARIETTA
State GA
ZIP 30068-4385
Accounting period End 12
Primary contact name DEREK B HULLENDER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DEREK HULLENDER
PRESIDENT & DIRECTOR
PMB421 4880 LWR ROSWELL RD STE 165
MARIETTA GA 30068-4385

Officer/Director/Trustee Two

DAVID RHODES
SECRETARY & DIRECTOR
PMB421 4880 LWR ROSWELL RD STE 165
MARIETTA GA 30068-4385

Officer/Director/Trustee Three

RUSSELL SYKES
TREASURER & DIRECTOR
PMB421 4880 LWR ROSWELL RD STE 165
MARIETTA GA 30068-4385

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/12/18
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code M23 - Search and Rescue Squads, Services
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name DEREK HULLENDER
Signature Title PRESIDENT & DIRECTOR
Signature Date 12/27/18

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