FORM 1023-EZ for GEORGIA CHILDHOOD DOMESTIC VIOLENCEASSOCIATION INC

Field Data
EIN 84-1864131
Case Number EO-2019154-000558
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GEORGIA CHILDHOOD DOMESTIC VIOLENCEASSOCIATION INC
Organization’s Mailing Address 5605 GLENRIDGE DRIVE NE STE 600
City ATLANTA
State GA
ZIP 30342
Accounting period End 12
Primary contact name LINDA OLSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHANTA DUBE
DIRECTOR
11015 LINBROOK LANE
JOHNS CREEK GA 30097

Officer/Director/Trustee Two

LINDA OLSON
TREASURER
740 CALWOOD CHASE
ROSWELL GA 30075

Officer/Director/Trustee Three

LISA JAMISON
SECRETARY
2297 DODSON DRIVE
EAST POINT GA 30344

Officer/Director/Trustee Four

VARADA DIVGI
OFFICER
4421 VILLAGE OAKS RIDGE
DUNWOODY GA 30348

Organization’s website HTTPS://CDV.ORG/ABOUT-US/GEORGIA-CDV/
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/9/19
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: No
Religious: No
Educational: Yes
Scientific: Yes
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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 SHANTA DUBE
Signature Title DIRECTOR
Signature Date 6/1/19

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