FORM 1023-EZ for PHOENIX INSTITUTE ATLANTA INC

Field Data
EIN 46-1525989
Case Number EO-2015240-000357
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PHOENIX INSTITUTE ATLANTA INC
Organization’s Mailing Address 23107 HARVEST RIDGE LANE
City JOHNS CREEK
State GA
ZIP 30022
Accounting period End 12
Primary contact name KATHRYN HAGGERTY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KATHRYN HAGGERTY
PRESIDENT
23107 HARVEST RIDGE LANE
JOHNS CREEK GA 30022

Officer/Director/Trustee Two

PHILOMENA SLATER
VICE PRESIDENT
23105 HARVEST RIDGE LANE
JOHNS CREEK GA 30022

Officer/Director/Trustee Three

DINA SHADWELL
SECRETARY
129 NORTHERN AVENUE APT 4
DECATUR GA 30030

Officer/Director/Trustee Four

PATRICIA OMALLEY
TREASURER
5276 COUNTRY CLUB VILLAGE LANE APTE
NORCROSS GA 30092

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/5/2012
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X11 - Single Organization Support
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 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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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