FORM 1023-EZ for MEMORY LANE LIVING INC

Field Data
EIN 84-3528291
Case Number EO-2020188-000512
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MEMORY LANE LIVING INC
Organization’s Mailing Address 2414 DALLAS HIGHWAY SUITE 100
City MARIETTA
State GA
ZIP 30064
Accounting period End 6
Primary contact name LIN TATUM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LIN TATUM
PRESIDENT
1900 BRITTANIA CIRCLE
WOODSTOCK GA 30188

Officer/Director/Trustee Two

RHONDA T RANDALL
VICE PRESIDENT
244 ASCOTT LN
WOODSTOCK GA 30189

Officer/Director/Trustee Three

CINDY NELSON
SECRETARY
2414 DALLAS HIGHWAY SUITE 100
MARIETTA GA 30064

Officer/Director/Trustee Four

JACQUI CLELLAND
TREASURER
8104 WOODLAND LANE
ALPHARETTA GA 30009

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/21/2020
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P80 - Services to Promote the Independence of Specific Populations
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 Yes
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 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 RHONDA T RANDALL
Signature Title VICE PRESIDENT
Signature Date 7/2/2020

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