FORM 1023-EZ for DESTROY PANCREATIC CANCER RESEARCH AND CARE FOUNDATION INC

Field Data
EIN 81-3982085
Case Number EO-2017040-000231
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DESTROY PANCREATIC CANCER RESEARCH AND CARE FOUNDATION INC
Organization’s Mailing Address 1455 LINCOLN PARKWAY SUITE 350
City ATLANTA
State GA
ZIP 30346-2209
Accounting period End 12
Primary contact name SHANNON N MANDEL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JACQUI FISCH
DIRECTOR
1455 LINCOLN PKWY SUITE 350
ATLANTA GA 30346-2209

Officer/Director/Trustee Two

JOHN COUVILLON
DIRECTOR
1455 LINCOLN PKWY SUITE 350
ATLANTA GA 30346-2209

Officer/Director/Trustee Three

HOWARD YOUNG
DIRECTOR
1455 LINCOLN PKWY SUITE 350
ATLANTA GA 30346-2209

Officer/Director/Trustee Four

DOUGLAS EVANS
DIRECTOR
1455 LINCOLN PKWY SUITE 350
ATLANTA GA 30346-2209

Officer/Director/Trustee Five

MICHAEL BROXTERMAN
DIRECTOR
1455 LINCOLN PKWY SUITE 350
ATLANTA GA 30346-2209

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/16/2016
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code H30 - Cancer Research
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 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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