FORM 1023-EZ for CHAMBERLAIN ACADEMY AND GROUP HOME
| Field | Data |
|---|---|
| EIN | 81-3226245 |
| Case Number | EO-2017046-000037 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | CHAMBERLAIN ACADEMY AND GROUP HOME |
| Organization’s Mailing Address | 1500 GILLIONVILLE ROAD STE B |
| City | ALBANY |
| State | GA |
| ZIP | 31707 |
| Accounting period End | 6 |
| Primary contact name | TANYA JONES |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
BRYAN CHAMBERLAIN
DIRECTOR
5652 STRATHMOOR MANOR CIRCLE
LITHONIA GA 30058
Officer/Director/Trustee Two
TANYA JONES
SECRETARY
2300 GLENEAGLES DRIVE
ALBANY GA 31707
Officer/Director/Trustee Three
BRANDI CHAMBERLAIN
PRESIDENT
533 EBONY LANE
ALBANY GA 31701
Officer/Director/Trustee Four
ORLANDO BIGGS
BOARD MEMBER
5652 STRATHMOOR MANOR CIRCLE
LITHONIA GA 30058
Officer/Director/Trustee Five
DEBORAH BEMBRY
BOARD MEMBER
608 MEADOWLARK DRIVE
ALBANY GA 31707
| Organization’s website | |
|---|---|
| Organization’s email | CHAMBERLAINAGH@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 7/16/2016 |
| Organization Incorporation State | GA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | P73 - Group Home (Long Term) |
| Organization’s purpose | Charitable: No 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 | 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 | No |
| Benefit of College | No |
| Private Foundation 508(e) | Yes |
| Seeking Retroactive Reinstatement | No |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | |
| Signature Title | |
| Signature Date |
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