FORM 1023-EZ for ROTARY CLUB OF POLK COUNTY GEORGIAUSA INC

Field Data
EIN 58-6043657
Case Number EO-2015054-000229
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ROTARY CLUB OF POLK COUNTY GEORGIAUSA INC
Organization’s Mailing Address PO BOX 901
City ROCKMART
State GA
ZIP 30153
Accounting period End 12
Primary contact name BRITT MADDEN JR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

AL CUNNINGHAM
PRESIDENT
45 STONEBROOK DR
ROCKMART GA 30153

Officer/Director/Trustee Two

BRITT MADDEN
TREASURER
1609 CAVE SPRING RD
CEDARTOWN GA 30125

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/17/2014
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S80 - Community Service Clubs
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
Literary: Yes
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 Yes
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 Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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