FORM 1023-EZ for THE HEALTH PARTNERSHIP OF GEORGIA INC

Field Data
EIN 82-1428622
Case Number EO-2017138-000458
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE HEALTH PARTNERSHIP OF GEORGIA INC
Organization’s Mailing Address 7274 BANKHEAD HIGHWAY SUITE C
City DOUGLASVILLE
State GA
ZIP 30134-1643
Accounting period End 12
Primary contact name SHEKINAH THOMAS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHEKINAH THOMAS
PRESIDENT
3869 ROSEDALE LANE
DOUGLASVILLE GA 30135-2741

Officer/Director/Trustee Two

ANGELENE THOMAS
VICE PRESIDENT
118 LAKE HURST DRIVE
DUDLEY NC 28333-9324

Officer/Director/Trustee Three

SUE ELLEN SIMMONS
TREASURER
26 BRROKSPINE STREET
VILLA RICA GA 30180-4007

Organization’s website
Organization’s email HEALTHPARTNERS@TPOGA.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/28/2017
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: 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
Signature Title
Signature Date

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