FORM 1023-EZ for JAMES E WORRALL FOUNDATION INC

Field Data
EIN 45-3620898
Case Number EO-2018039-000132
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name JAMES E WORRALL FOUNDATION INC
Organization’s Mailing Address PO BOX 2030
City PERRY
State GA
ZIP 31069
Accounting period End 6
Primary contact name TRACI S BASS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOHN HULBERT
CHAIRMAN
PO BOX 2030
PERRY GA 31069

Officer/Director/Trustee Two

FELIX SMITH
CO-CHAIRMAN
PO BOX 2030
PERRY GA 31069

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/14/11
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N32 - Parks and Playgrounds
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JOHN HULBERT
Signature Title CHAIRMAN
Signature Date 2/6/18

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