FORM 1023-EZ for IMPACT CENTER GEORGIA INC

Field Data
EIN 81-4700470
Case Number EO-2020281-000081
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name IMPACT CENTER GEORGIA INC
Organization’s Mailing Address 158 S HOUSTON LAKE RD SUITE 10
City WARNER ROBINS
State GA
ZIP 31088
Accounting period End 12
Primary contact name PATRICIA STANLEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PATRICIA STANLEY
PRESIDENT
158 S HOUSTON LAKE RD SUITE 10
WARNER ROBINS GA 31088

Officer/Director/Trustee Two

ALVIN STANLEY
VICE PRESIDENT
158 S HOUSTON LAKE RD SUITE 10
WARNER ROBINS GA 31088

Officer/Director/Trustee Three

CINDY BAILEY
TREASURER
158 S HOUSTON LAKE RD SUITE 10
WARNER ROBINS GA 31088

Officer/Director/Trustee Four

JANET LAMAR
SECRETARY
158 S HOUSTON LAKE RD SUITE 10
WARNER ROBINS GA 31088

Officer/Director/Trustee Five

SHANNON STRAFFORD
DIRECTOR
158 S HOUSTON LAKE RD SUITE 10
WARNER ROBINS GA 31088

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/20/2016
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
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 Yes
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name PATRICIA STANLEY
Signature Title PRESIDENT
Signature Date 10/5/2020

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