FORM 1023-EZ for MOM FOUNDATION INC

Field Data
EIN 81-4856389
Case Number EO-2017088-000292
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MOM FOUNDATION INC
Organization’s Mailing Address 389 PAVILLION STREET
City ATLANTA
State GA
ZIP 30315
Accounting period End 12
Primary contact name DEBORAH COPELAND
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DEBORAH COPELAND
PRESIDENT
389 PAVILLION STREET
ATLANTA GA 30315

Officer/Director/Trustee Two

PAIGE BURNS
MEMBER
7467 TOCCOA CIRCLE
UNION CITY GA 30291

Officer/Director/Trustee Three

KATRINA NORTHINGTON
SECRETARY
2955 FORESTSIDE LANE
COLLEGE PARK GA 30349

Officer/Director/Trustee Four

ROBERT HUDSON
TREASURER
76 BELMONTE CIRCLE
ATLANTA GA 30311

Officer/Director/Trustee Five

LYNETTE COPELAND
MEMBER
389 PAVILLION STREET SE
ATLANTA GA 30315

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/14/2016
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L80 - Housing Support Services -- Other
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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