FORM 1023-EZ for AKUSA INC

Field Data
EIN 84-3621148
Case Number EO-2021104-000045
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name AKUSA INC
Organization’s Mailing Address 1645 ALCOVY RIVER DRIVE
City DACULA
State GA
ZIP 30019
Accounting period End 12
Primary contact name HORTENSE OROS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ESAIE YAO KOUAME
PRESIDENT
1494 JERNIGAN BLUFF
LAWRENCEVILLE GA 30045

Officer/Director/Trustee Two

CORINNE ICE
SECRETARY
1645 ALCOVY RIVER DRIVE
DACULA GA 30019

Officer/Director/Trustee Three

JOACHIM NGUESSAN
ASSISTANT SECRETARY
4925 CENTRAL AVE APT 15
CHARLOTTE NC 28205

Officer/Director/Trustee Four

DOMINIQUE ICE
TREASURER
1645 ALCOVY RIVER DRIVE
DACULA GA 30019

Officer/Director/Trustee Five

PHILOMENE YOBOUET
COMMISSIONER OF AUDIT
8260 WEST RIVER ROAD 112
BROOKLYN PARK MN 55444

Organization’s website
Organization’s email MARCKOFF40@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/7/2019
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Y40 - Fraternal Beneficiary Societies
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 Yes
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 DOMINIQUE ICE
Signature Title TREASURER
Signature Date 4/7/2021

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