FORM 1023-EZ for MARCHELL ANDERSON FOUNDATION

Field Data
EIN 46-3698711
Case Number EO-2018317-000229
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MARCHELL ANDERSON FOUNDATION
Organization’s Mailing Address 1260 GLENWOOD AVENUE SE
City ATLANTA
State GA
ZIP 30316
Accounting period End 12
Primary contact name JACK L BENNETT CPA POA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ALFRED JONES
CFO
110 GILBERT
FAYETTEVILLE GA 30214

Officer/Director/Trustee Two

DAVID HARRIS
SECRETARY
2537 CORNER SHOALS
DECATUR GA 30032

Officer/Director/Trustee Three

JUAN ROSE
CEO
1260 GLENWOOD AVENUE SE
ATLANTA GA 30316

Organization’s website WWW.THEMARCELLANDERSONFOUNDATION.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/28/14
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JUAN ROSE
Signature Title CEO
Signature Date 11/8/18
EIN 46-3698711
Case Number EO-2015240-000279
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MARCHELL ANDERSON FOUNDATION
Organization’s Mailing Address 534 FLAT SHOALS AVE SE
City ATLANTA
State GA
ZIP 30316
Accounting period End 12
Primary contact name JUAN ROSE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ALFRED JONES
CHAIR
110 GILBERT ST
FAYETTEVILLE GA 30214

Officer/Director/Trustee Two

JUAN ROSE
INCORPORATOR
534 FLAT SHOALS AVENUE SE
ATLANTA GA 30316

Officer/Director/Trustee Three

SHELDON GRAHAM
DIRECTOR
4755 GRESHAM ROAD
DECATUR GA 30034

Officer/Director/Trustee Four

ALESIA ALEXANDER
DIRECTOR
1103 PARK ROW SOUTH SE
ATLANTA GA 30312

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/28/2014
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code I31 - Transitional Care, Half-Way House for Offenders, Ex-Offenders
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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