FORM 1023-EZ for COLUMBIA HIGH SCHOOL ALUMNI ASSOCIATION INC

Field Data
EIN 27-4457270
Case Number EO-2016187-000321
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name COLUMBIA HIGH SCHOOL ALUMNI ASSOCIATION INC
Organization’s Mailing Address 3650 MOUNTAIN COVE RD
City SNELLVILLE
State GA
ZIP 30039
Accounting period End 12
Primary contact name JORETHA HARRISON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DERRICK BUTTS
PRESIDENT
3650 MOUNTAIN COVE RD
SNELLVILLE GA 30039

Officer/Director/Trustee Two

WILLIE FLOYD
VICE PRESIDENT
2967 KNOLLBERRY LN
DECATUR GA 30034

Officer/Director/Trustee Three

JORETHA HARRISON
TREASURER
3610 GARNET WAY
SNELLVILLE GA 30039

Officer/Director/Trustee Four

NATASHA FOSTER
SECRETARY
3724 RIVER LAKE SHORE
ELLENWOOD GA 30294

Officer/Director/Trustee Five

TABITHA CURTIS
ASST. SECRETARY
3983 GLENWOOD DOWNS LN
DECATUR GA 30035

Organization’s website
Organization’s email CHSALUMNI1@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/15/2016
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Y11 - Single Organization Support
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 Yes
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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