FORM 1023-EZ for MIA MADISON ARTS AND AWARENESS CENTER

Field Data
EIN 84-1771255
Case Number EO-2019200-000216
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MIA MADISON ARTS AND AWARENESS CENTER
Organization’s Mailing Address 3581 AVENSONG VILLAGE CIRCLE
City ALPHARETTA
State GA
ZIP 30004
Accounting period End 12
Primary contact name EDDIE CROCKETT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

EDDIE CROCKETT
PRESIDENT
3581 AVENSONG VILLAGE CIRCLE
ALPHARETTA GA 30004

Officer/Director/Trustee Two

JODIE CROCKETT
SECRETARY
3581 AVENSONG VILLAGE CIRCLE
ALPHARETTA GA 30004

Officer/Director/Trustee Three

TAMIA MADISON CROCKETT
TREASURER
3581 AVENSONG VILLAGE CIRCLE
ALPHARETTA GA 30004

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/17/19
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: 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 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 EDDIE CROCKETT
Signature Title PRESIDENT
Signature Date 7/17/19

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