FORM 1023-EZ for WALTON COUNTY DOMESTIC VIOLENCE TASK FORCE

Field Data
EIN 20-4928440
Case Number EO-2021097-000044
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name WALTON COUNTY DOMESTIC VIOLENCE TASK FORCE
Organization’s Mailing Address P O BOX 670
City MONROE
State GA
ZIP 30655
Accounting period End 12
Primary contact name LACY MARTIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RICK BAKER
CHAIR
P O BOX 670
MONROE GA 30655

Officer/Director/Trustee Two

PAIGE LEWIS
SECRETARY
P O BOX 670
MONROE GA 30655

Officer/Director/Trustee Three

LACY MARTIN
TREASURER
303 HAMMOND DR
MONROE GA 30655

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/10/2021
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Z99 - Unclassified
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name RICK BAKER
Signature Title CHAIR
Signature Date 3/10/2021

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