FORM 1023-EZ for MEDALLION OF HOPE INC

Field Data
EIN 80-0530169
Case Number EO-2015056-000175
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MEDALLION OF HOPE INC
Organization’s Mailing Address 101 SOUTHERN OAKS LANE
City BLACKSHEAR
State GA
ZIP 31516
Accounting period End 12
Primary contact name GUYNELL GRANT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

GUYNELL GRANT
CEO
101 SOUTHERN OAKS LANE
BLACKSHEAR GA 31516

Officer/Director/Trustee Two

LENNIS PAULK
CHAIRMAN
190 MELVIN PAULK LANE
BAXLEY GA 31513

Officer/Director/Trustee Three

GLENNIS PAULK
CO-CHAIRMAN
190 MELVIN PAULK LANE
BAXLEY GA 31513

Officer/Director/Trustee Four

ALBERT GRANT
VOLUNTEER
101 SOUTHERN OAKS LANE
BLACKSHEAR GA 31516

Officer/Director/Trustee Five

SINNEL F PAULK
SECRETARY
190 MELVIN PAULK
BAXLEY GA 31513

Organization’s website
Organization’s email MEDALLIONHOPE@YMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/21/2010
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X12 - 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 Yes
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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