FORM 1023-EZ for GA FAITH COMMUNITY NURSING CENTER INC

Field Data
EIN 82-1677326
Case Number EO-2017191-000419
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name GA FAITH COMMUNITY NURSING CENTER INC
Organization’s Mailing Address 5471 MEMORIAL DR SUITE G
City STONE MOUNTAIN
State GA
ZIP 30083
Accounting period End 12
Primary contact name YOLAINE NOZILE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

YOLAINE NOZILE
PRES
4213 SCENIC MOUNTAIN DR
SNELLVILLE GA 30039

Officer/Director/Trustee Two

CHARLES BERNATH
REGISTERED AGENT, TRUSTEE
PO BOX 768154
ROSWELL GA 30076

Organization’s website
Organization’s email YNOZILE@GAHEALTHCARETRAINING.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/3/2017
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 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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