FORM 1023-EZ for DOLLYS PERSONAL CARE HOME OUTREACHINC

Field Data
EIN 83-1915635
Case Number EO-2018264-000292
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DOLLYS PERSONAL CARE HOME OUTREACHINC
Organization’s Mailing Address 555 COTTON CREEK LANE
City WINDER
State GA
ZIP 30680
Accounting period End 12
Primary contact name CYNTHIA VINCENT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CYNTHIA VINCENT
TREASURER
555 COTTON CREEK LANE
WINDER GA 30680

Officer/Director/Trustee Two

AGNES ELLIOTT TAYLOR
PRESIDENT
555 COTTON CREEK LANE
WINDER GA 30680

Officer/Director/Trustee Three

TONIA HORACE
SECRETARY
555 COTTON CREEK LANE
WINDER GA 30680

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/25/18
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W99 - Public, Society Benefit - Multipurpose and Other N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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 Yes
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 CYNTHIA VINCENT
Signature Title TREASURER
Signature Date 9/19/18
EIN 83-1915635
Case Number EO-2018264-000292
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DOLLYS PERSONAL CARE HOME OUTREACH INC
Organization’s Mailing Address 555 COTTON CREEK LANE
City WINDER
State GA
ZIP 30680
Accounting period End 12
Primary contact name CYNTHIA VINCENT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CYNTHIA VINCENT
TREASURER
555 COTTON CREEK LANE
WINDER GA 30680

Officer/Director/Trustee Two

AGNES ELLIOTT TAYLOR
PRESIDENT
555 COTTON CREEK LANE
WINDER GA 30680

Officer/Director/Trustee Three

TONIA HORACE
SECRETARY
555 COTTON CREEK LANE
WINDER GA 30680

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/25/18
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W99 - Public, Society Benefit - Multipurpose and Other N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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 Yes
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 CYNTHIA VINCENT
Signature Title TREASURER
Signature Date 9/19/18

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