FORM 1023-EZ for CANCARE ATLANTA GA CHAPTER INC

Field Data
EIN 83-3676101
Case Number EO-2019095-000130
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CANCARE ATLANTA GA CHAPTER INC
Organization’s Mailing Address 10950 BELL ROAD
City JOHNS CREEK
State GA
ZIP 30097
Accounting period End 12
Primary contact name CHESTER ELVIN BURDICK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NEAL KUHLHORST
PRESIDENT
10950 BELL ROAD
JOHNS CREEK GA 30097

Officer/Director/Trustee Two

CHESTER BURDICK
TREASURER
6190 BLUFF HEIGHTS DRIVE
CUMMING GA 30040

Officer/Director/Trustee Three

KAY ROYAL
DIRECTOR
10950 BELL ROAD
JOHNS CREEK GA 30097

Officer/Director/Trustee Four

GLORIA GAYTERS
SECRETARY
5645 VICARAGE WALK
ALPHARETTA GA 30097

Officer/Director/Trustee Five

MIRIELLE WHITENOUR
DIRECTOR
10950 BELL ROAD
JOHNS CREEK GA 30097

Organization’s website HTTPS://CANCARE.ORG/CHAPTERS/ATLANTA-CHAPTER/
Organization’s email CHETBURDICK@BELLSOUTH.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/23/19
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G30 - Cancer
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 CHESTER BURDICK
Signature Title TREASURER
Signature Date 4/3/19

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