FORM 1023-EZ for LAKE TARN LAKELOT OWNERS ASSOCIATION

Field Data
EIN 58-1865148
Case Number EO-2017310-000494
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LAKE TARN LAKELOT OWNERS ASSOCIATION
Organization’s Mailing Address 5203 LEGENDARY LANE
City ACWORTH
State GA
ZIP 30102
Accounting period End 12
Primary contact name KEVIN WILSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KEVIN WILSON
PRESIDENT
5203 LEGENDARY LANE
ACWORTH GA 30102

Officer/Director/Trustee Two

JAMES LEDOUX
VICE PRESIDENT
676 ASHLEY FOREST DRIVE
ACWORTH GA 30102

Officer/Director/Trustee Three

ROBERT KOLODZIEJSKI
TREASURER
5189 PINE CLIFF TARN
ACWORTH GA 30102

Organization’s website
Organization’s email KMOGRAM@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/21/1989
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: 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
Signature Title
Signature Date

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