FORM 1023-EZ for GWENS SWAN INCORPORATED

Field Data
EIN 86-2082627
Case Number EO-2021090-000015
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GWENS SWAN INCORPORATED
Organization’s Mailing Address 587 WARRENTON DRIVE
City DOUGLASVILLE
State GA
ZIP 30134-6324
Accounting period End 12
Primary contact name DLORAH BUTTSLUCAS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SUSAN BUCKSON
CEO AND DIRECTOR
587 WARRENTON DRIVE
DOUGLASVILLE GA 30134-6324

Officer/Director/Trustee Two

AMBE COMEAUX
SECRETARY AND DIRECTOR
3057 PHARR COURT NORTH NW APT E5
ATLANTA GA 30305-2020

Officer/Director/Trustee Three

DARRYL STEWART
CFO AND DIRECTOR
587 WARRENTON DRIVE
DOUGLASVILLE GA 30134-6324

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/20/2020
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 Yes
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 SUSAN BUCKSON
Signature Title CEO AND DIRECTOR
Signature Date 2/16/2021

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