FORM 1023-EZ for DBSA CHATTANOOGA PENDULUMS

Field Data
EIN 90-0185162
Case Number EO-2017144-000168
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DBSA CHATTANOOGA PENDULUMS
Organization’s Mailing Address 268 CARMACK
City FLINTSTONE
State GA
ZIP 30725
Accounting period End 12
Primary contact name JOE HERMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOE HERMAN
PRESIDENT
268 CARMACK RD
FLINTSTONE GA 30725

Officer/Director/Trustee Two

RUTH DELANGE
SECRETARY
10 BATTERY DR
ROSSVILLE GA 30741

Officer/Director/Trustee Three

NELLI SICHWART
TREASURER
25 WOODARD CIR
EAST RIDGE TN 37412

Organization’s website DBSACHATTANOOGA.ORG
Organization’s email JOE@DBSACHATTANOOGA.ORG
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/20/2017
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: No
Religious: No
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
Signature Title
Signature Date

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