FORM 1023-EZ for THE BROCK FOUNDATION INC
| Field | Data |
|---|---|
| EIN | 85-4121184 |
| Case Number | EO-2021078-000860 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | THE BROCK FOUNDATION INC |
| Organization’s Mailing Address | 4290 BELLS FERRY ROAD SUITE 134 |
| City | KENNESAW |
| State | GA |
| ZIP | 30144 |
| Accounting period End | 12 |
| Primary contact name | ABRIEL A DAVIS |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
OMAR R BROCK
OFFICER
PO BOX 1723
DOUGLASVILLE GA 30133
Officer/Director/Trustee Two
FALLON MERCEDES-BROCK
VICE PRESIDENT
PO BOX 1723
DOUGLASVILLE GA 30133
Officer/Director/Trustee Three
REGENIA DURHAM
SECRETARY
PO BOX 1202
LITHIA SPRINGS GA 30122
Officer/Director/Trustee Four
ABRIEL DAVIS
TREASURY
146 SILVER ARROW CIRCLE
AUSTELL GA 30168
| Organization’s website | THEBROCKFOUNDATIONINC.COM |
|---|---|
| Organization’s email | BROCKAVIATIONORG@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 11/16/2020 |
| Organization Incorporation State | GA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | O99 - Youth Development N.E.C. |
| 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 | 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 | No |
| Benefit of College | No |
| Private Foundation 508(e) | Yes |
| Seeking Retroactive Reinstatement | No |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | OMAR R BROCK |
| Signature Title | OFFICER |
| Signature Date | 1/23/2021 |
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