FORM 1023-EZ for PEACH STATE COMMUNITY INVOLVEMENT AGENCY
| Field | Data |
|---|---|
| EIN | 84-3784830 |
| Case Number | EO-2020259-000139 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | PEACH STATE COMMUNITY INVOLVEMENT AGENCY |
| Organization’s Mailing Address | 1012 BLUECOAT CIR |
| City | HAMPTON |
| State | GA |
| ZIP | 30228 |
| Accounting period End | 12 |
| Primary contact name | REGINALD WALTON |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
REGINALD WALTON
CEO, PRESIDENT
1012 BLUECOAT CIR
HAMPTON GA 30228
Officer/Director/Trustee Two
MARQUITA WALTON
CFO,
1012 BLUECOAT CIR
HAMPTON GA 30228
| Organization’s website | HTTPS://WWW.PSCIA.ORG |
|---|---|
| Organization’s email | COMMUNICATIONS@PSCIA.ORG |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 1/7/2020 |
| Organization Incorporation State | GA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | P20 - Human Service Organizations - Multipurpose |
| Organization’s purpose | Charitable: Yes Religious: No 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 | Yes |
| 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 | Yes |
| 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 | REGINALD WALTON |
| Signature Title | CEO, PRESIDENT |
| Signature Date | 9/13/2020 |
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