FORM 1023-EZ for ANGEL OF MERCY INC

Field Data
EIN 47-3945042
Case Number EO-2019231-000345
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ANGEL OF MERCY INC
Organization’s Mailing Address 161 SAWTOOTH OAK DR
City JEFFERSON
State GA
ZIP 30549
Accounting period End 12
Primary contact name JAMES ETHERIDGE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAMES ETHERIDGE
PRESIDENT
161 SAWTOOTH OAK DR
JEFFERSON GA 30549

Officer/Director/Trustee Two

MARY ETHERIDGE
VICE PRESIDENT
161 SAWTOOTH OAK DR
JEFFERSON GA 30549

Officer/Director/Trustee Three

ROBERT DAVIS
SECRETARY
PO BOX 366
WHEELERSBURG OH 45694

Officer/Director/Trustee Four

MICHAEL SEALS
TREASURER
2909 WASHINGTON AVE
TERRE HAUTE IN 47803

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/10/15
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: Yes
Religious: Yes
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 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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JAMES ETHERIDGE
Signature Title PRESIDENT
Signature Date 8/15/19

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