FORM 1023-EZ for HELPERS HEALTH AND COMMUNITY INITIATIVES INCORPORATED

Field Data
EIN 46-5765905
Case Number EO-2016040-000033
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HELPERS HEALTH AND COMMUNITY INITIATIVES INCORPORATED
Organization’s Mailing Address 735 PARKLEIGH COURT
City ATLANTA
State GA
ZIP 30331-7694
Accounting period End 12
Primary contact name RUCHELLE THOMAS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

RUCHELLE THOMAS
CEO
735 PARKLEIGH COURT
ATLANTA GA 30331-7694

Officer/Director/Trustee Two

FELICIA BURRELL
SECRETARY
223 SCENIC VIEW DRIVE
ATLATNA GA 30339

Officer/Director/Trustee Three

JUDITH FAIRCLOUGH
TREASURER
6604 GA-85
RIVERDALE GA 30274-2347

Officer/Director/Trustee Four

DR EBONY LOVE MD
MEDICAL ADVISOR
541 GEORGIA CIRCLE
LOGANVILLE GA 30052-6938

Officer/Director/Trustee Five

DR BRYAN BLAKE MD
CHIEF MEDICAL OFFICER/ADVISOR
939 THORNTON ROAD
LITHIA SPRINGS GA 30112-2634

Organization’s website HTTP://WWW.HELPERSHCI.ORG/
Organization’s email RTHELPERS@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/19/2014
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E60 - Health Support Services
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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