FORM 1023-EZ for MARIETTA ROAD SENIOR HIGHRISE INC

Field Data
EIN 81-3812951
Case Number EO-2016258-000216
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MARIETTA ROAD SENIOR HIGHRISE INC
Organization’s Mailing Address 2295 MARIETTA ROAD NW APT 208
City ATLANTA
State GA
ZIP 30318
Accounting period End 12
Primary contact name DUSTIN M JACKSON EA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TONY MARTIN
CEO
2295 MARIETTA ROAD NW UNIT 208
ATLANTA GA 30318

Officer/Director/Trustee Two

ANNIE ALEXANDER
CFO
2295 MARIETTA ROAD NW UNIT 208
ATLANTA GA 30318

Officer/Director/Trustee Three

ANNIE BROOKS
SECRETARY
2295 MARIETTA ROAD NW UNIT 208
ATLANTA GA 30318

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/3/1995
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S22 - Neighborhood, Block Associations
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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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