FORM 1023-EZ for TIM BARTA FOUNDATION

Field Data
EIN 84-3021626
Case Number EO-2019277-000853
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TIM BARTA FOUNDATION
Organization’s Mailing Address 3650 ASHFORD DUNWOODY RDNE UNIT 821
City BROOKHAVEN
State GA
ZIP 30319
Accounting period End 12
Primary contact name NATHAN SKIDMORE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NATHAN SKIDMORE
DIRECTOR
3650 ASHFORD DUNWOODY RDNE UNIT 821
BROOKHAVEN GA 30319

Officer/Director/Trustee Two

LAURA HART
TREASURER
91 PARKMONT DR
ROSWELL GA 30076

Officer/Director/Trustee Three

SCOTT VOORHEES
OFFICER
301 BRANDYWINE CIR
SANDY SPRINGS GA 30350

Officer/Director/Trustee Four

CHRISTINA RENAN
OFFICER
55 KATHY COURT
CANTON GA 30114

Officer/Director/Trustee Five

CAMILLE FOX
OFFICER
10900 SHALLOWFORD RD
ROSWELL GA 30075

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/12/19
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N12 - Fund Raising and/or Fund Distribution
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 Yes
Correctness Declaration Yes
Signature Name NATHAN SKIDMORE
Signature Title DIRECTOR
Signature Date 10/2/19

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