FORM 1023-EZ for SURVIVOR THRIVE EVANGELISTIC MINISTRIES INC

Field Data
EIN 85-0851282
Case Number EO-2020136-000200
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SURVIVOR THRIVE EVANGELISTIC MINISTRIES INC
Organization’s Mailing Address 359 MADDOX CIR
City JACKSON
State GA
ZIP 30233
Accounting period End 12
Primary contact name KEVIN HORNSBY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KEVIN HORNSBY
PRESIDENT, DIRECTOR
359 MADDOX CIR
JACKSON GA 30233

Officer/Director/Trustee Two

JODY HORNSBY
TREASURER, DIRECTOR
359 MADDOX CIR
JACKSON GA 30233

Officer/Director/Trustee Three

SCOTT CAMPBELL
SECRETARY, DIRECTOR
185 DUB WALKER DR
JACKSON GA 30233

Officer/Director/Trustee Four

EDDIE PRIDGEON
DIRECTOR
920 N COURTNEY RD
PERRY FL 32347

Officer/Director/Trustee Five

ROY HAZELRIG
DIRECTOR
3630 SOUTH OLA RD
LOCUST GROVE GA 30248

Organization’s website WWW.SURVIVORTHRIVE.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/21/2020
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
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 KEVIN HORNSBY
Signature Title PRESIDENT, DIRECTOR
Signature Date 5/13/2020

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