FORM 1023-EZ for AHC

Field Data
EIN 84-4142288
Case Number EO-2020006-000637
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name AHC
Organization’s Mailing Address 1398 CHRISTIANA DRIVE
City LAWRENCEVILLE
State GA
ZIP 30043
Accounting period End 12
Primary contact name ANITA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANITA PRINCE
CEO
1398 CHRISTIANA DRIVE
LAWRENCEVILLE GA 30043

Officer/Director/Trustee Two

CARLOS NELSON
PRESIDENT
1398 CHRISTIANA DRIVE
LAWRECEVILLE GA 30043

Officer/Director/Trustee Three

BELINDA OFORI GYAMPOH
VICE PRESIDENT
1398 CHRISTIANA DRIVE
LAWRENCEVILLE GA 30043

Officer/Director/Trustee Four

BENJY ATKINSON
BUSINESS MANAGER
1085 SAN MARCOS COVE
LAWRENCCEVILLE GA 30043

Officer/Director/Trustee Five

EDNA MCFOY
TREASURER
1085 SAN MARCOS COVE
LAWRENCEVILLE GA 30043

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/4/2020
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E90 - Nursing Services (General)
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 Yes
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 ANITA PRINCE
Signature Title CEO
Signature Date 1/4/2020

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