FORM 1023-EZ for THE CITIZEN FOUNDATION

Field Data
EIN 26-4038818
Case Number EO-2017005-000250
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE CITIZEN FOUNDATION
Organization’s Mailing Address 5193 AUSTELL ROAD
City AUSTELL
State GA
ZIP 30106
Accounting period End 12
Primary contact name EDWARD CITIZEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

EDWARD CITIZEN
OFFICER
5193 AUSTELL ROAD
AUSTELL GA 30106

Officer/Director/Trustee Two

NIKITA CITIZEN
OFICER
3970 BROOK HOLLOW DR
DOUGLASVILLE GA 30135

Officer/Director/Trustee Three

MIKE MASON
OFFICER
7104 HWY 166
DOUGLASVILLE GA 30135

Organization’s website
Organization’s email JAYSHREENATH@BELLSOUTH.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/2/2009
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: 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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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