FORM 1023-EZ for MACEDONIA CEMETERY

Field Data
EIN 74-3052620
Case Number EO-2015245-000300
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MACEDONIA CEMETERY
Organization’s Mailing Address 291 COOPER RD
City SUMMERVILLE
State GA
ZIP 30747-6127
Accounting period End 12
Primary contact name ANN MADDUX
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DOUG SHAMBLIN
CHAIRMAN
488 EAST TELOGA RD
SUMMERVILLE GA 30747

Officer/Director/Trustee Two

ANN MADDUX
VICE CHAIRMAN
291 COOPER RD
SUMMERVILLE GA 30747-6127

Officer/Director/Trustee Three

MACK GILREATH
BOARD MEMBER
10545 HWY 337
SUMMERVILLE GA 30747

Officer/Director/Trustee Four

JO SHAMBLIN
TREASURER
11110 HWY 337
SUMMERVILLE GA 30747

Officer/Director/Trustee Five

SARAH JANE HOOD
BOARD MEMBER
8177 HWY 337
SUMMERVILLE GA 30747

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/2014
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Y50 - Cemeteries, Burial Services
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 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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