FORM 1023-EZ for AGAPE LIFE PREVENTION CENTER CORPORATION

Field Data
EIN 83-3234328
Case Number EO-2020090-000294
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name AGAPE LIFE PREVENTION CENTER CORPORATION
Organization’s Mailing Address 6071 HIGHWAY 85 APT 31A
City RIVERDALE
State GA
ZIP 30274
Accounting period End 12
Primary contact name TIARA BRACEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DARUIS WILSON
PRESIDENT, DIRECTOR
1278 CAHABA DR
ATLANTA GA 30326

Officer/Director/Trustee Two

JASMINE ANDREWS
SECRETARY, DIRECTOR
9102 FAIRINGTON RIDGE CIR
DECATUR GA 30038

Officer/Director/Trustee Three

BRITTANI NILES
TREASURER, DIRECTOR
2406 AVONLEA WAY
GAINESVILLE GA 30504

Officer/Director/Trustee Four

TIARA BRACEY
DIRECTOR
6071 HIGHWAY 85 APT 31A
RIVERDALE GA 30274

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/30/2018
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds Yes
Conducting Activities Outside of United States Yes
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 TIARA BRACEY
Signature Title DIRECTOR
Signature Date 3/27/2020

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