FORM 1023-EZ for CRISP AREA PREGNANCY CARE CENTER

Field Data
EIN 81-2582063
Case Number EO-2016160-000157
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CRISP AREA PREGNANCY CARE CENTER
Organization’s Mailing Address 2116 HIGHWAY 41 NORTH
City CORDELE
State GA
ZIP 31015
Accounting period End 12
Primary contact name GARY LEUTZINGER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

GARY LEUTZINGER
PRESIDENT, CHAIRPERSON
2116 HIGHWAY 41 NORTH
CORDELE GA 31015

Officer/Director/Trustee Two

DEBBIE BLOODWORTH
TREASURER
1624 PINEVIEW PITTS HIGHWAY
PINEVIEW GA 31071

Officer/Director/Trustee Three

DREW ANDERSON
VICE-PRESIDENT
302 EAST 12TH AVENUE
CORDELE GA 31015

Officer/Director/Trustee Four

LAURA GARLAND
SECRETARY
1031 EAST 24TH AVENUE
CORDELE GA 31015

Officer/Director/Trustee Five

ALLISON BOWEN
BOARD MEMBER
311 HUDSON ROAD
VIENNA GA 31092

Organization’s website NA
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/11/2016
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: Yes
Religious: Yes
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 No
One Third Support Gifts Yes
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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