FORM 1023-EZ for GEORGIA COMMUNITY COALITION INC

Field Data
EIN 47-2136315
Case Number EO-2015044-000132
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name GEORGIA COMMUNITY COALITION INC
Organization’s Mailing Address 2561 AUSTELL ROAD SUITE 100
City MARIETTA
State GA
ZIP 30008
Accounting period End 12
Primary contact name MICHAEL DORSEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MICHAEL DORSEY
PRESIDENT
1461 ENNISBROOK DR
SMYRNA GA 30082

Officer/Director/Trustee Two

COAKLEY PENDERGRASS
VICE PRESIDENT
428 CEDAR TRACE SW
MARIETTA GA 30008

Officer/Director/Trustee Three

JAMES WASHINGTON
TREASURER
4873 SHANNON GREEN COURT
MABLETON GA 30126

Officer/Director/Trustee Four

KENNETH HOWELL
MARKETING DIRECTOR
749 BIRCHWOOD LN SW
MARIETTA GA 30060

Officer/Director/Trustee Five

ANDREA SEARLES
SECRETARY
1470 WHITFIELD ST
SMYRNA GA 30080

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/4/2014
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S21 - Community Coalitions
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 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
Signature Title
Signature Date

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