FORM 1023-EZ for EMS CARES FOUNDATION

Field Data
EIN 47-3628451
Case Number EO-2015099-000443
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name EMS CARES FOUNDATION
Organization’s Mailing Address 3760 TRAMORE POINTE PKWY
City AUSTELL
State GA
ZIP 30106
Accounting period End 12
Primary contact name SHANE GARRISON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

RICKIE SHANE
CHAIRMAN
3760 TRAMORE POINTE PKWY
AUSTELL GA 30106

Officer/Director/Trustee Two

STEVE PUCKETT
VICE CHAIRMAN
3760 TRAMORE POINTE PKWY
AUSTELL GA 30106

Officer/Director/Trustee Three

TERRY JOHNSON
TREASURER
428 MIRAGE DR
DALLAS GA 30157

Officer/Director/Trustee Four

JAKE LONAS
SECRETARY
3760 TRAMORE POINTE PKWY
AUSTELL GA 30106

Officer/Director/Trustee Five

WAYNE DODD
BOARD MEMBER
3760 TRAMORE POINTE PKWY
AUSTELL GA 30106

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/24/2015
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W12 - Fund Raising and/or Fund Distribution
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
Signature Title
Signature Date

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