FORM 1023-EZ for SHORT SHOOTOUT BREAST CANCER FUND INC

Field Data
EIN 82-4233456
Case Number EO-2018089-000454
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SHORT SHOOTOUT BREAST CANCER FUND INC
Organization’s Mailing Address 999 PEACHTREE STREET NE SUITE 2300
City ATLANTA
State GA
ZIP 30309-3996
Accounting period End 12
Primary contact name HERBERT J SHORT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LISA SHORT
PRESIDENT
1015 W WESLEY RD NW
ATLANTA GA 30327-1311

Officer/Director/Trustee Two

HERBERT SHORT
SECRETARY-TREASURER
1015 W WESLEY ROAD NW
ATLANTA GA 30327-1311

Officer/Director/Trustee Three

MADISON SHORT
VICE PRESIDENT
55 DELMONT DRIVE APT A2
ATLANTA GA 30305-3140

Officer/Director/Trustee Four

KATHERINE MERLINO
VICE PRESIDENT
2192 EDISON AVE NE
ATLANTA GA 30305-4309

Officer/Director/Trustee Five

SPAIN SHORT
VICE PRESIDENT
1015 W WESLEY RD NW
ATLANTA GA 30327-1311

Organization’s website N/A
Organization’s email SHORTSHOOTOUT@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/24/18
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T50 - Philanthropy, Charity, Voluntarism Promotion, General
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 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 LISA SHORT
Signature Title PRESIDENT
Signature Date 3/28/18

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