FORM 1023-EZ for ANCIENT AFRICAN HISTORY MUSEUM INC

Field Data
EIN 84-1845888
Case Number EO-2019148-000399
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ANCIENT AFRICAN HISTORY MUSEUM INC
Organization’s Mailing Address PO BOX 5996
City DOUGLASVILLE
State GA
ZIP 30154-17
Accounting period End 12
Primary contact name MELISSA K ANDERSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MELISSA ANDERSON
CHIEF EXECUTIVE OFFICER
PO BOX 5996
DOUGLASVILLE GA 30154-17

Officer/Director/Trustee Two

SHENEANE RAGIN
SECRETARY
PO BOX 5996
DOUGLASVILLE GA 30154-17

Officer/Director/Trustee Three

KAREN POYTHRESS
TREASURER
PO BOX 5996
DOUGLASVILLE GA 30154-17

Organization’s website ANCIENTAFRICANHISTORYMUSEUM.COM
Organization’s email INFO@ANCIENTAFRICANORALHISTORYMUSEUM.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/2/19
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A54 - History Museums
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 No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
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 MELISSA ANDERSON
Signature Title CHIEF EXECUTIVE OFFICER
Signature Date 5/23/19

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