FORM 1023-EZ for DOUGLAS COUNTY HOMELESS COALITION PREV DO COUNTY CONTINUUM OF CARE

Field Data
EIN 58-2424320
Case Number EO-2019092-000509
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DOUGLAS COUNTY HOMELESS COALITION PREV DO COUNTY CONTINUUM OF CARE
Organization’s Mailing Address 2709 GENTRY DRIVE
City DOUGLASVILLE
State GA
ZIP 30135
Accounting period End 12
Primary contact name LEIGH ANN CHAMPION
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LEIGH ANN CHAMPION
CHAIRMAN
2709 GENTRY DRIVE
DOUGLASVILLE GA 30135

Officer/Director/Trustee Two

TAMMY KONE
TREASURER
8366 GRADY ST
DOUGLASVILLE GA 30135

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/30/98
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P85 - Homeless Persons 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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name LEIGH ANN CHAMPION
Signature Title CHAIRMAN
Signature Date 3/31/19

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