FORM 1023-EZ for ETC GEORGIA INC

Field Data
EIN 83-0578635
Case Number EO-2019038-000163
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ETC GEORGIA INC
Organization’s Mailing Address 3309 BOLD SPRINGS RD
City DACULA
State GA
ZIP 30019
Accounting period End 12
Primary contact name MONA STEPHENS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MONA STEPHENS
PRESIDENT
3309 BOLD SPRINGS RD
DACULA GA 30016

Officer/Director/Trustee Two

PATTI VOHS
SECRETARY
2999 PATE ROAD
LOGANVILLE GA 30052

Officer/Director/Trustee Three

SALLY MANSOUR
TREASURER
1203 FAIRWINDS DRIVE
LOGANVILLE GA 30052

Officer/Director/Trustee Four

ALAN MCDANIEL
DIRECTOR
4000 MINNOW COURT
LOGANVILLE GA 30052

Officer/Director/Trustee Five

CYNTHIA HOUSTON
DIRECTOR
5627 STONINGTON TRACE PKWY
STONE MOUNTAIN GA 30087

Organization’s website ETCGEORGIA.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/11/18
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D20 - Animal Protection and Welfare
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 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 MONA STEPHENS
Signature Title PRESIDENT
Signature Date 1/29/19

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