FORM 1023-EZ for CONTINUING CARE HALL OF FAME INC

Field Data
EIN 47-4874915
Case Number EO-2021298-000525
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CONTINUING CARE HALL OF FAME INC
Organization’s Mailing Address 1791 WOODCLIFFE TERRACE NE
City ATLANTA
State GA
ZIP 30324
Accounting period End 12
Primary contact name VALERIE R SUSSMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ALWYN POWELL
PRESIDENT & DIRECTOR
1791 WOODCLIFFE TERRACE NE
ATLANTA GA 30324

Officer/Director/Trustee Two

JAMES GLYNN
SECRETARY & DIRECTOR
208 HOWARD DRIVE
BELLAIRE FL 33786

Officer/Director/Trustee Three

WILLIAM SWIFT
TREASURER & DIRECTOR
2568 LAKE ERMA DRIVE
HAMPTON GA 30228

Organization’s website
Organization’s email INFO@CCHOFFAME.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/12/2015
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
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 No
One Third Support Public Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ALWYN POWELL
Signature Title PRESIDENT & DIRECTOR
Signature Date 10/22/2021
EIN 47-4874915
Case Number EO-2015247-000248
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CONTINUING CARE HALL OF FAME INC
Organization’s Mailing Address 1791 WOODCLIFFE TERRACE NE
City ATLANTA
State GA
ZIP 30324-4955
Accounting period End 12
Primary contact name MERTON S MARSH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ALWYN POWELL
PRESIDENT CEO
1791 WOODCLIFFE TERRACE NE
ATLANTA GA 30324-4955

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/12/2015
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B60 - Adult, Continuing Education
Organization’s purpose Charitable: No
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 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
Signature Title
Signature Date

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