FORM 1023-EZ for CLIP INCORPORATED - CHANGING LIVESIN PROGRESS

Field Data
EIN 47-1603176
Case Number EO-2016077-000116
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CLIP INCORPORATED - CHANGING LIVESIN PROGRESS
Organization’s Mailing Address 850 VALLA CRUCIS LANE
City DACULA
State GA
ZIP 30019
Accounting period End 12
Primary contact name HENRIETTA ACOLATSE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TAKEIDA ADANIJO
PRESIDENT
850 VALLA CRUCIS LANE
DACULA GA 30019

Officer/Director/Trustee Two

QUOVADIS THOMAS
SECRETARY
850 VALLA CRUCIS LANE
DACULA GA 30019

Officer/Director/Trustee Three

JENNIFER ALEXANDER-BEHARIE
TREASURER
850 VALLA CRUCIS LANE
DACULA GA 30019

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/2/2014
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W99 - Public, Society Benefit - Multipurpose and Other N.E.C.
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 No
Conducting Activities Outside of United States Yes
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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