FORM 1023-EZ for CITIZEN AGAINST VIOLENCE MINISTRY INC

Field Data
EIN 81-5279902
Case Number EO-2017292-000303
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CITIZEN AGAINST VIOLENCE MINISTRY INC
Organization’s Mailing Address 624 E JANE ST
City VALDOSTA
State GA
ZIP 31601
Accounting period End 12
Primary contact name JD MARTAIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JD MARTIN
CEO
3709 ROBIN LANE
VALDOSTA GA 31605

Officer/Director/Trustee Two

ETHEL MARTIN
SEC/TREASURER
3709 ROBIN LANE
VALDOSTA GA 31605

Officer/Director/Trustee Three

DAVID ADAMS
VICE-CHAIR
2826 ARROWLEAF DR
VALDOSTA GA 31602

Officer/Director/Trustee Four

JOE TROOPE
CHAIRMAN
2401 SMITH ST
VALDOSTA GA 31601

Officer/Director/Trustee Five

WYLENE MOBLEY
DIRECTOR
2517 FREDRICK AVE
VALDOSTA GA 31602

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/31/2016
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code I20 - Crime Prevention N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 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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