FORM 1023-EZ for MELODIOUS MEDICATION ORGANIZATION

Field Data
EIN 85-1886780
Case Number EO-2020274-000194
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MELODIOUS MEDICATION ORGANIZATION
Organization’s Mailing Address 220 SPLITWOOD LANE
City FAIRBURN
State GA
ZIP 30213
Accounting period End 12
Primary contact name NAQUOSHA JACKSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NAQUOSHA JACKSON
CEO
220 SPLITWOOD LANE
FAIRBURN GA 30213

Officer/Director/Trustee Two

NICOLE WILLIAMS
CFO
4900 DELANO RD APT 17D
COLLEGE PARK GA 30213

Officer/Director/Trustee Three

VENUS CORBIN-MAY
TREASER
32 VANESSA DR
SMYRNA GA 30349

Officer/Director/Trustee Four

RANEE PRATT
SECRETARY
1802 BROAD RIVER RD
COLLEGE PARK GA 30349

Officer/Director/Trustee Five

MELODY BEATLES
REGISTERED AGENT
82 VANESS DR
SMYRNA GA 30349

Organization’s website MELODIOUSMEDICATION4SICKLECELL.ORG
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/17/2019
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
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 Yes
Gaming Activity No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name NAQUOSHA JACKSON
Signature Title CEO
Signature Date 9/28/2020

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