FORM 1023-EZ for SHARE HEALTH SOUTHEAST GEORGIA INC

Field Data
EIN 47-5608447
Case Number EO-2016028-000147
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SHARE HEALTH SOUTHEAST GEORGIA INC
Organization’s Mailing Address 1101 CHURCH STREET
City WAYCROSS
State GA
ZIP 31501
Accounting period End 6
Primary contact name GAIL SEIFERT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

GAIL SEIFERT
CHAIR
P O BOX 2801
WAYCROSS GA 31502

Officer/Director/Trustee Two

CLAY GILL
VICE CHAIR
P O BOX 151
PATTERSON GA 31557

Officer/Director/Trustee Three

MARIAN TABI
SECRETARY
P O BOX 8158
STATESBORO GA 30460

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/25/2015
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: Yes
Religious: No
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 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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