FORM 1023-EZ for DOUGLASVILLE ISLAMIC WOMENS SHELTERAND SERICES INC

Field Data
EIN 85-3420660
Case Number EO-2020300-000470
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DOUGLASVILLE ISLAMIC WOMENS SHELTERAND SERICES INC
Organization’s Mailing Address 4970 WYNFORD LANE
City DOUGLASVILLE
State GA
ZIP 30134
Accounting period End 10
Primary contact name NATYSHIA SMITH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NATYSHIA SMITH
EXECUTIVE DIRECTOR
PO BOX 244
DOUGLASVILLE GA 30134

Officer/Director/Trustee Two

MAURENE SMITH
TREASURER- BOARD MEMBER
7501 SILVERMINE XING
AUSTELL GA 30168

Officer/Director/Trustee Three

TANISHA WILLIAMS
BOARD MEMBER
1753 THOMAS POINTE TRACE
LAWRENCEVILLE GA 30043

Officer/Director/Trustee Four

CARMELLA DUNCAN
BOARD MEMBER
1066 S 320TH ST APT F407
FEDERAL WAY WA 98003

Organization’s website www.diwsas.org
Organization’s email info.diwsas@gmail.com
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/13/2020
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P43 - Family Violence Shelters, Services
Organization’s purpose Charitable: Yes
Religious: Yes
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 NATYSHIA SMITH
Signature Title EXECUTIVE DIRECTOR
Signature Date 10/22/2020

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