FORM 1023-EZ for MARY LOUS PLACE

Field Data
EIN 82-2226502
Case Number EO-2017208-000415
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MARY LOUS PLACE
Organization’s Mailing Address 610 MORNING DR
City ATLANTA
State GA
ZIP 30349
Accounting period End 4
Primary contact name MICHELLE COLBERT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHELLE COLBERT
CEO
610 MORNING DRIVE
ATLANTA GA 30349

Officer/Director/Trustee Two

EBONY BETHEA
SECRETARY
11492 ALICIA CT
HAMPTON GA 30228

Officer/Director/Trustee Three

TONI BING
VICE PRESIDENT
494 HEATHROW WAY
STONE MOUNTAIN GA 30087

Officer/Director/Trustee Four

MICHELLE JOHNSON
PRESIDENT
3930 EVELYN DR
AUSTELL GA 30127

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/26/2016
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
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 No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance Yes
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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