FORM 1023-EZ for JKJ HOMECARE INC

Field Data
EIN 47-3680823
Case Number EO-2015264-000341
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name JKJ HOMECARE INC
Organization’s Mailing Address 3021 BONNEVILLE DRIVE
City MACON
State GA
ZIP 31204
Accounting period End 12
Primary contact name VERONDA FORD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CARLTON KITCHENS
PRESIDENT
3021 BONNEVILLE DRIVE
MACON GA 31204-3636

Officer/Director/Trustee Two

VERONDA FORD
VICE PRESIDENT
708 HENNEPIN TERRACE
MCDONOUGH GA 30253

Officer/Director/Trustee Three

BOB FICKLING
TREASURER
203 AMALIE DRIVE
MACON GA 31220

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/12/2014
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P85 - Homeless Persons Centers, Services
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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