FORM 1023-EZ for CONCERNED YOPUTH OF AMERICA INC

Field Data
EIN 83-0457500
Case Number EO-2020260-000257
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CONCERNED YOPUTH OF AMERICA INC
Organization’s Mailing Address 2361 HURT ST
City MILLEDGEVILLE
State GA
ZIP 31061
Accounting period End 12
Primary contact name ANNIE MILLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANNIE MILLER
CEO
2361 HURT ST
MILLEDEVILLE GA 31061

Officer/Director/Trustee Two

KIMCHEE MILLER
SECRETARY
2361 HURT ST
MILLEDGEVILLE GA 31061

Officer/Director/Trustee Three

VERNON MILLER SR
CFO
2361 HURT ST
MILLEDGEVILLE GA 31061

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/15/2011
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B11 - Single Organization Support
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 Yes
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 Yes
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 Yes
Correctness Declaration Yes
Signature Name ANNIE MILLER
Signature Title CEO
Signature Date 9/14/2020

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