FORM 1023-EZ for THE ELLIJAY POLICE DEPARTMENT FOUNDATION INC

Field Data
EIN 82-4692626
Case Number EO-2019280-000354
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE ELLIJAY POLICE DEPARTMENT FOUNDATION INC
Organization’s Mailing Address 197 N MAIN ST
City ELLIJAY
State GA
ZIP 30540
Accounting period End 12
Primary contact name CRYSTAL NADOLSKI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DOUG COLBURN
CFO
197 N MAIN ST
ELLIJAY GA 30540

Officer/Director/Trustee Two

EDWARD LACEY
CEO
197 N MAIN ST
ELLIJAY GA 30540

Officer/Director/Trustee Three

CRYSTAL NADOLSKI
SECRETARY
71 RIVER ST
ELLIJAY GA 30540

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/27/18
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code M12 - Fund Raising and/or Fund Distribution
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 CRYSTAL NADOLSKI
Signature Title SECRETARY
Signature Date 10/4/19

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