FORM 1023-EZ for JEFFERSON COUNTY CONCERNED CITIZENSCOMMITTEE INC

Field Data
EIN 84-4577643
Case Number EO-2020104-000398
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name JEFFERSON COUNTY CONCERNED CITIZENSCOMMITTEE INC
Organization’s Mailing Address 1771 HIGHWAY 24 EAST
City LOUISVILLE
State GA
ZIP 30434
Accounting period End 12
Primary contact name DIANE FLOURNOY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

EUGENE WASHINGTON
CHAIRPERSON
1771 HIGHWAY 24 EAST
LOUISVILLE GA 30434

Officer/Director/Trustee Two

CHARLES WASHINGTON
VICE CHAIRPERSON
202 DENNY ROAD
WRENS GA 30833

Officer/Director/Trustee Three

LARKIN WILLIAMS
TREASURER
604 HIGHWAY 17 SOUTH
LOUISVILLE GA 30434

Officer/Director/Trustee Four

JOANNE MCCULLOUGH
SECRETARY
1047 WALNUT STREE
LOUISVILLE GA 30434

Officer/Director/Trustee Five

L D BOYD
PARLIAMENTARIAN
725 OLD US 1
LOUISVILLE GA 30434

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/19/2020
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S01 - Alliance/Advocacy Organizations
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 No
Correctness Declaration Yes
Signature Name EUGENE WASHINGTON
Signature Title CHAIRPERSON
Signature Date 4/11/2020

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