FORM 1023-EZ for EUGENE BULLARD SOCIETY INTERNATIONAL

Field Data
EIN 37-1879182
Case Number EO-2018128-000978
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name EUGENE BULLARD SOCIETY INTERNATIONAL
Organization’s Mailing Address 8097 ROSWELL ROAD BLDG C SUITE 202
City ATLANTA
State GA
ZIP 30350-6160
Accounting period End 12
Primary contact name MARK HENDERSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARK HENDERSON
FOUNDER & CEO
3376 TURTLE LAKE DR SE
MARIETTA GA 30067-5090

Officer/Director/Trustee Two

MARY CHERYL HENDERSON
SECRETARY/TREASURER
3376 TURTLE LAKE DR SE
MARIETTA GA 30067-5090

Officer/Director/Trustee Three

CHARLES WING
DIRECTOR
5219 BROOKE FARM DRIVE
DUNWOODY GA 30338-3148

Officer/Director/Trustee Four

FERNANDO POLAR
DIRECTOR
8097 ROSWELL ROAD BLDG C SUITE 202
ATLANTA GA 30350-6160

Officer/Director/Trustee Five

LUIS TORRES-BOHL
DIRECTOR
8097 ROSWELL ROAD BLDG C SUITE 202
ATLANTA GA 30350-6160

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/18/17
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A23 - Cultural, Ethnic Awareness
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 MARK HENDERSON
Signature Title FOUNDER & CEO
Signature Date 5/3/18

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