FORM 1023-EZ for PATH TO VISION CORP

Field Data
EIN 82-2491363
Case Number EO-2017317-000597
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PATH TO VISION CORP
Organization’s Mailing Address 40 MALLARD POINTE DRIVE
City DOUGLAS
State GA
ZIP 31535
Accounting period End 12
Primary contact name SIDNEY L COTTINGHAM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ADRIAN LEWIS
PRESIDENT
40 MALLARD POINTE DRIVE
DOUGLAS GA 31535

Officer/Director/Trustee Two

BRANDY LEWIS
SECRETARY/TREASURER
200 CRESTVIEW CHURCH RD APRT 1102
WARNER ROBINS GA 31088

Officer/Director/Trustee Three

DERRICK GREEN
DIRECTOR
370 CROMWELL CIRCLE
DOUGLAS GA 31535

Officer/Director/Trustee Four

AMY HANCOCK
DIRECTOR
331 RED BUD DRIVE
OCILLA GA 31774

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/25/2017
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code J20 - Employment Procurement Assistance, Job Training
Organization’s purpose Charitable: No
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 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
Signature Title
Signature Date

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