FORM 1023-EZ for HEAL ATLANTA INC

Field Data
EIN 84-3418463
Case Number EO-2019298-000341
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HEAL ATLANTA INC
Organization’s Mailing Address 2146 ROSWELL ROAD SUITE 108-868
City MARIETTA
State GA
ZIP 30062
Accounting period End 12
Primary contact name DANA DESCHENE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DANA DESCHENE
CEO
2146 ROSWELL ROAD SUITE 108-868
MARIETTA GA 30062

Officer/Director/Trustee Two

LUCY LEHMAN
CFO
892 EDGEWATER CIRCLE
MARIETTA GA 30062

Officer/Director/Trustee Three

CLINTON BEASLEY
SECRETARY
PO BOX 2367
WOODSTOCK GA 30188

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/27/19
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: 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 Yes
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name DANA DESCHENE
Signature Title CEO
Signature Date 10/23/19

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