| Field | Data |
|---|---|
| EIN | 81-1056293 |
| Case Number | EO-2016256-000332 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | SOUTHERN GRACE HOSPICE FOUNDATION INC |
| Organization’s Mailing Address | 384 RACETRACK RD |
| City | MCDONOUGH |
| State | GA |
| ZIP | 30252 |
| Accounting period End | 12 |
| Primary contact name | AUBREY KEKIWI |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
AUBREY KEKIWI
PRESIDENT
384 RACETRACK RD
MCDONOUGH GA 30252
JIM WEATHERS
VICE PRESIDENT
190 WILLOW WAY
STOCKBRIDGE GA 30281
PAMELA ATKINSON
SECRETARY
100 COMMERCE DRIVE NUM 397
TYRONE GA 30290
GLENN BERILLE
TREASURER
8014 CUMMING HWY
CANTON GA 30115
MOBIN SHAH
BOARD MEMBER
352 LONGSHIRE DR
MCDONOUGH GA 30253
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 8/14/2014 |
| Organization Incorporation State | GA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | P80 - Services to Promote the Independence of Specific Populations |
| 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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