FORM 1023-EZ for CONASAUGA FAMILY VIOLENCE ALLIANCEINC

Field Data
EIN 47-1103936
Case Number EO-2015272-000044
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CONASAUGA FAMILY VIOLENCE ALLIANCEINC
Organization’s Mailing Address PO BOX 984
City DALTON
State GA
ZIP 30722
Accounting period End 12
Primary contact name JIM SNEARY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MARCY MULLER
CO-CHAIR
PO BOX 984
DALTON GA 30722

Officer/Director/Trustee Two

PALLAVI MANAY
CO-CHAIR
PO BOX 984
DALTON GA 30722

Officer/Director/Trustee Three

JIM SNEARY
TREASURER
PO BOX 984
DALTON GA 30722

Officer/Director/Trustee Four

SUE JORDAN
SECRETARY
PO BOX 984
DALTON GA 30722

Officer/Director/Trustee Five

WESLEY LYNCH
VICE-CHAIR
PO BOX 984
DALTON GA 30722

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/22/2014
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code I70 - Protection Against, Prevention of Neglect, Abuse, Exploitation
Organization’s purpose Charitable: No
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 Yes
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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