FORM 1023-EZ for SERVING AFFECTING LEADING & TEACHING OUTREACH MINISTRY

Field Data
EIN 83-3630641
Case Number EO-2019102-000247
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SERVING AFFECTING LEADING & TEACHING OUTREACH MINISTRY
Organization’s Mailing Address 427 KING ARNOLD STREET
City HAPEVILLE
State GA
ZIP 30354
Accounting period End 4
Primary contact name CLAUDIA SMALLS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CLAUDIA SMALLS
CEO
350 CASCADE RISE COURT
ATLANTA GA 30331

Officer/Director/Trustee Two

VALENCIA DORSEY
CFO
1625 CONLEY ROAD
CONLEY GA 30288

Officer/Director/Trustee Three

TINA BRANTLEY
SECRETARY
11 BLUFF COURT
HIRAM GA 30141

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/21/19
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: Yes
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 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 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 CLAUDIA SMALLS
Signature Title CEO
Signature Date 4/10/19

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