FORM 1023-EZ for SUPREME NUTRITION INC

Field Data
EIN 85-2965901
Case Number EO-2021091-001109
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SUPREME NUTRITION INC
Organization’s Mailing Address 4695 REGENCY TRACE SW
City ATLANTA
State GA
ZIP 30331
Accounting period End 12
Primary contact name DEVON PETTWAY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DEVON PETTWAY
PRESIDENT
4695 REGENCY TRACE SW
ATLANTA GA 30040

Officer/Director/Trustee Two

GLENDA MORTON
SECRETARY
4695 REGENCY TRACE SW
ATLANTA GA 30331

Officer/Director/Trustee Three

JAMI PETTWAY
TREASURER
4695 REGENCY TRACE SW
ATLANTA GA 30331

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/3/2020
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K40 - Nutrition Programs
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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 DEVON PETTWAY
Signature Title PRESIDENT
Signature Date 2/22/2021

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