FORM 1023-EZ for HOUSE OF THABITHA

Field Data
EIN 84-4571120
Case Number EO-2020111-000372
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HOUSE OF THABITHA
Organization’s Mailing Address 12102 DUNLEAF ARC WAY
City NORCROSS
State GA
ZIP 30093
Accounting period End 12
Primary contact name EMMANUELA NEBA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

EMMANUELA NEBA
CEO
12102 DUNLEAF ARC WAY
NORCROSS GA 30093

Officer/Director/Trustee Two

EMMANUELA NEBA
CEO
12102 DUNLEAF ARC WAY
NORCROSS GA 30093

Officer/Director/Trustee Three

EDNA WILLIAM
SECRETARY
44 AUTUMN DR
FITCHBURG MA 01420

Officer/Director/Trustee Four

GRACE AWANTU TANGIE
CFO
12102 DUNLEAF ARC WAY
NORCROSS GA 30093

Officer/Director/Trustee Five

BLAISE KENGJISE
REGISTERED AGENT
1805 LAUREL CREEK DR
LAWRENCEVILLE GA 30043

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/2/2020
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P83 - Senior Centers
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 Yes
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 EMMANUELA NEBA
Signature Title CEO
Signature Date 4/17/2020

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