FORM 1023-EZ for EMPOWERED BY PINK INC

Field Data
EIN 47-4862872
Case Number EO-2018109-000547
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name EMPOWERED BY PINK INC
Organization’s Mailing Address 2217 BLUE RIDGE LANE
City CONYERS
State GA
ZIP 30012-2864
Accounting period End 12
Primary contact name PRISCILLA CAMP
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PRISCILLA CAMP
COO
2217 BLUE RIDGE LANE
CONYERS GA 30012-2864

Officer/Director/Trustee Two

DIANE MILLS
CFO
1206 MISTYHAYNE WAY
GRAYSON GA 30017-4291

Officer/Director/Trustee Three

KENDRA SMITH
SECRETARY
705 PARKER PLACE
ATLANTA GA 30349-7923

Organization’s website WWW.EMPOWEREDBYPINK.ORG
Organization’s email PINKPOWER@BELLSOUTH.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/15/15
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion 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 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 PRISCILLA CAMP
Signature Title COO
Signature Date 4/17/18

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