FORM 1023-EZ for RYAN LEE HOLLAND CANCER FOUNDATIONINC

Field Data
EIN 45-2226464
Case Number EO-2019072-000506
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name RYAN LEE HOLLAND CANCER FOUNDATIONINC
Organization’s Mailing Address 11877 DOUGLAS ROAD STE 102 262
City ALPHARETTA
State GA
ZIP 30005
Accounting period End 12
Primary contact name HENRIETTA ACOLATSE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

COURTNEY MARIE HOLLAND
TREASURER
11877 DOUGLAS ROAD STE 102 262
ALPHARETTA GA 30005

Officer/Director/Trustee Two

JACQUELINE UREY
PRESIDENT
11877 DOUGLAS ROAD STE 102 262
ALPHARETTA GA 30005

Officer/Director/Trustee Three

JAQUELINE AMENIA
SECRETARY
11877 DOUGLAS ROAD STE 102 262
ALPHARETTA GA 30005

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/6/11
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W99 - Public, Society Benefit - Multipurpose and Other N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
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 Yes
Correctness Declaration Yes
Signature Name JACQUELINE UREY
Signature Title PRESIDENT
Signature Date 3/11/19
EIN 45-2226464
Case Number EO-2019072-000506
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name RYAN LEE HOLLAND CANCER FOUNDATION INC
Organization’s Mailing Address 11877 DOUGLAS ROAD STE 102 262
City ALPHARETTA
State GA
ZIP 30005
Accounting period End 12
Primary contact name HENRIETTA ACOLATSE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

COURTNEY MARIE HOLLAND
TREASURER
11877 DOUGLAS ROAD STE 102 262
ALPHARETTA GA 30005

Officer/Director/Trustee Two

JACQUELINE UREY
PRESIDENT
11877 DOUGLAS ROAD STE 102 262
ALPHARETTA GA 30005

Officer/Director/Trustee Three

JAQUELINE AMENIA
SECRETARY
11877 DOUGLAS ROAD STE 102 262
ALPHARETTA GA 30005

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/6/11
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W99 - Public, Society Benefit - Multipurpose and Other N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
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 Yes
Correctness Declaration Yes
Signature Name JACQUELINE UREY
Signature Title PRESIDENT
Signature Date 3/11/19

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