FORM 1023-EZ for EXHILARATION4 INC

Field Data
EIN 26-3510850
Case Number EO-2020073-000210
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name EXHILARATION4 INC
Organization’s Mailing Address 4041 ANVIL BLOCK ROAD
City ELLENWOOD
State GA
ZIP 30294-2637
Accounting period End 12
Primary contact name SHARON TYLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHARON TYLER
PRESIDENT
40471 ANVIL BLOCK ROAD
ELLENWOOD GA 30294-2637

Officer/Director/Trustee Two

TREVITT KINGDOM
TREASURER
2685 CALHOUN ROAD
VIENNA GA 31092-5725

Officer/Director/Trustee Three

NATASHA TERRELL
SECRETARY
4041 ANVIL BLOCK ROAD
ELLENWOOD GA 30294-2637

Organization’s website
Organization’s email EXHILARATION4@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/1/2019
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G41 - Eye Diseases, Blindness and Vision Impairments
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 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 SHARON TYLER
Signature Title PRESIDENT
Signature Date 3/11/2020

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