FORM 1023-EZ for NICOLA SMITH JACKSON FOUNDATION INC

Field Data
EIN 84-2796055
Case Number EO-2019235-000300
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name NICOLA SMITH JACKSON FOUNDATION INC
Organization’s Mailing Address 2104 ADEL DRIVE
City LOGANVILLE
State GA
ZIP 30052-4740
Accounting period End 12
Primary contact name NICOLA SMITH JACKSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NICOLA SMITH JACKSON
CHARIMAN
2104 ADEL DRIVE
LOGANVILLE GA 30052-4740

Officer/Director/Trustee Two

MARCIA GRAYS
TREASURER
7972 ERROL DRIVE
LITHONIA GA 30058-1539

Officer/Director/Trustee Three

KATRINA NEWBY
SECRETARY
1744 KANAWHA DRIVE
STONE MOUNTAIN GA 30087-2123

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/21/19
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W70 - Leadership Development
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 No
Correctness Declaration Yes
Signature Name NICOLA SMITH JACKSON
Signature Title CHARIMAN
Signature Date 8/21/19

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