FORM 1023-EZ for GRACE HOUSE AUGUSTA INC

Field Data
EIN 83-2313804
Case Number EO-2019144-000241
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GRACE HOUSE AUGUSTA INC
Organization’s Mailing Address 1841 OHIO AVE
City AUGUSTA
State GA
ZIP 30904
Accounting period End 12
Primary contact name JESSICA HUNT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LINDA GRIJALVA
PRESIDENT
3948 CASA ROSA AVE
MARTINEZ GA 30907

Officer/Director/Trustee Two

MARY CLARK
VICE PRESIDENT
817 DUNBARTON DR
NORTH AUGUSTA SC 29841

Officer/Director/Trustee Three

ALICE SHUFORD
TREASURER
1325 MILLEDGE RD
AUGUSTA GA 30904

Officer/Director/Trustee Four

GINGER WEBB
SECERTARY
4567 MULBERRY CREEK DR
EVANS GA 30809

Officer/Director/Trustee Five

KURT WORTHINGTON
LEGAL COUNSEL
421 RICHMOND ST
EVANS GA 30809

Organization’s website WWW.GRACEHOUSEAUGUSTA.COM
Organization’s email JHUNTGRACEHOUSE@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/6/18
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F22 - Alcohol, Drug Abuse, Treatment Only
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: Yes
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 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 LINDA GRIJALVA
Signature Title PRESIDENT
Signature Date 5/22/19

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