FORM 1023-EZ for ROCK ISLAND ORGANIZATION

Field Data
EIN 86-3259815
Case Number EO-2021130-000159
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ROCK ISLAND ORGANIZATION
Organization’s Mailing Address 235 PEACHTREE STREET NE STE 444
City ATLANTA
State GA
ZIP 30303
Accounting period End 12
Primary contact name CYNTHIA ADAMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROSS DIXON
DIRECTOR
235 PEACHTREE STREET NE STE 444
ATLANTA GA 30303

Officer/Director/Trustee Two

SYLVESTER JACKSON
TREASURER
5192 BARRINGTON TRACE DR
ATLANTA GA 30331

Officer/Director/Trustee Three

DALIA DIXON
SECRETARY
4209 MAY APPLE LANE
ATLANTA GA 30349

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/16/2021
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P40 - Family 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 ROSS DIXON
Signature Title DIRECTOR
Signature Date 5/6/2021

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