FORM 1023-EZ for INEZA VILLAGE INC

Field Data
EIN 82-4725346
Case Number EO-2019070-000249
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name INEZA VILLAGE INC
Organization’s Mailing Address 245 SHORELINE DR
City FAYETTEVILLE
State GA
ZIP 30215
Accounting period End 12
Primary contact name ANNE MARIE MUKANKUSI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHONTERRIA MARTIN STOKES
CFO
829 FAIRWAYS COURT SUITE 210
STOCKBRIDGE GA 30281

Officer/Director/Trustee Two

DENISE SKELTON
MEMBER
930 DAVIS BEND RD
ALPHARETTA GA 30004

Officer/Director/Trustee Three

ANNE MARIE MUKANKUSI
PRESIDENT
245 SHORELINE DR
FAYETTEVILLE GA 30215

Officer/Director/Trustee Four

LOUISA MERCHANT
MEMBER
634 WEST PEACHTREE NW
ATLANTA GA 30308

Officer/Director/Trustee Five

CHIMENE MUCYOERA
SECRETARY
580 N LAND APT 18
STONE MOUNTAIN GA 30083

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/26/18
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 Yes
Donation of funds Yes
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 ANNE MARIE MUKANKUSI
Signature Title PRESIDENT
Signature Date 3/8/19

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