FORM 1023-EZ for PROVIDENCE PRESERVATION FOUNDATION INC
| Field | Data |
|---|---|
| EIN | 82-1067794 |
| Case Number | EO-2017096-000412 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | PROVIDENCE PRESERVATION FOUNDATION INC |
| Organization’s Mailing Address | 1665 PINEHURST VIEW DRIVE |
| City | GRAYSON |
| State | GA |
| ZIP | 30017 |
| Accounting period End | 12 |
| Primary contact name | HENRIETTA ACOLATSE |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
AMIN MODA MODAD
BOARD MEMBER
1665 PINEHURST VIEW DRIVE
GRAYSON GA 30017
Officer/Director/Trustee Two
DR CLARICE FORD KULAH
PRESIDENT
1665 PINEHURST VIEW DRIVE
GRAYSON GA 30017
Officer/Director/Trustee Three
DR DAWN COOPER BARNES
SECRETARY
1665 PINEHURST VIEW DRIVE
GRAYSON GA 30017
Officer/Director/Trustee Four
JOSEPH VAN VICKER
TREASURER
1665 PINEHURST VIEW DRIVE
GRAYSON GA 30017
Officer/Director/Trustee Five
HENRIETTA ACOLATSE
BOARD MEMBER
1665 PINEHURST VIEW DRIVE
GRAYSON GA 30017
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 1/12/2017 |
| Organization Incorporation State | GA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | W99 - Public, Society Benefit - Multipurpose and Other N.E.C. |
| Organization’s purpose | Charitable: Yes Religious: No Educational: Yes Scientific: No Literary: Yes Public Safety: No Amateur Sports: No Cruelty Prevention: Yes |
| Qualify For Exemption | No |
| Legislation influence | No |
| Compensation of Officer director trustee | No |
| Donation of funds | No |
| Conducting Activities Outside of United States | Yes |
| Financial transactions with officers | No |
| Unrelated Gross Income $1,000 or More | No |
| Gaming Activity | No |
| Disaster relief assistance | Yes |
| One Third Support Public | Yes |
| One Third Support Gifts | No |
| 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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