FORM 1023-EZ for HAPPY CAPS INC

Field Data
EIN 81-1224171
Case Number EO-2016049-000213
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HAPPY CAPS INC
Organization’s Mailing Address 142 FLAGSTONE WAY
City ACWORTH
State GA
ZIP 30101
Accounting period End 4
Primary contact name KATHERINE DEJOSEPH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KATHERINE DEJOSEPH
PRESIDENT
142 FLAGSTONE WAY
ACWORTH GA 30101

Officer/Director/Trustee Two

JULIA MILLER
VICE PRESIDENT
347 LIBERTY DRIVE
ACWORTH GA 30102

Officer/Director/Trustee Three

CHRISTINE DEPPEN
SECRETARY
391 THORNCLIFF LANDING
ACWORTH GA 30101

Officer/Director/Trustee Four

KATHLEEN MANSFIELD
DIRECTOR, PATIENT REPRESENTATION
5347 EVIAN CROSSING NW
KENNESAW GA 30152

Officer/Director/Trustee Five

ADAIRE MCGILL
TREASURER
24629 JONES ROAD
HEMPSTEAD TX 77445

Organization’s website HAPPYCAPSATLANTA.ORG
Organization’s email KATHYDEJO@COMCAST.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/15/2015
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P58 - Gift Distribution
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 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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