FORM 1023-EZ for UNION COUNTY SENIOR CENTER

Field Data
EIN 51-0623337
Case Number EO-2017130-000404
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name UNION COUNTY SENIOR CENTER
Organization’s Mailing Address 95 SENIOR CENTER DRIVE
City BLAIRSVILLE
State GA
ZIP 30512
Accounting period End 12
Primary contact name KATHY HILL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOHN CONKLE
TRUSTEE
761 EMERINE RD
BLAIRSVILLE GA 30512

Officer/Director/Trustee Two

RALPH HOLDSWORTH
TRUSTEE
2571 MURPHY HWY
BLAIRSVILLE GA 30512

Officer/Director/Trustee Three

POLLY MILLHOLLAND
TRUSTEE
761 EMERINE RD
BLAIRSVILLE GA 30512

Officer/Director/Trustee Four

URSULA WHITELOCK
TRUSTEE
233 CYPRESS EDGE DR
BLAIRSVILLE GA 30512

Officer/Director/Trustee Five

ROY WHITELOCK
TRUSTEE
233 CYPRESS EDGE DR
BLAIRSVILLE GA 30512

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/2/2007
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P81 - Senior Centers, 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 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
Signature Title
Signature Date

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