FORM 1023-EZ for INTERNATIONAL CENTER FOR ADOLESCENTS IN NEED INC

Field Data
EIN 20-5212508
Case Number EO-2016022-000290
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name INTERNATIONAL CENTER FOR ADOLESCENTS IN NEED INC
Organization’s Mailing Address 1702 BOULDER WALK LANE
City ATLANTA
State GA
ZIP 30316-3991
Accounting period End 12
Primary contact name SHADONNA DAVIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SHADONNA DAVIS
CHIEF EXECUTIVE OFFICER
1702 BOULDER WALK LANE
ATLANTA GA 30316-3991

Officer/Director/Trustee Two

TANEISHA LEE
CHIEF OPERATIONS OFFICER
2004 SANTENAY DRIVE
MARIETTA GA 30008-8817

Officer/Director/Trustee Three

CARRIE OLIVER
OFFICER
2307 A JIM STOKES CT
ALBANY GA 31721-2232

Officer/Director/Trustee Four

ANETRA MANGUM
OFFICER
5061 IRVINE DRIVE
DOUGLASVILLE GA 30135-2042

Officer/Director/Trustee Five

NORMAN ROBINSON III
OFFICER
4574 PAMELA PLACE
LITHONIA GA 30038-3695

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/30/2008
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
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 Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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