FORM 1023-EZ for SMOKE RISE ELEMENTARY FOUNDATION INC

Field Data
EIN 26-2641650
Case Number EO-2018040-000145
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SMOKE RISE ELEMENTARY FOUNDATION INC
Organization’s Mailing Address 4896 HUGH HOWELL ROAD
City STONE MOUNTAIN
State GA
ZIP 30087
Accounting period End 7
Primary contact name LISA KHEMANI EXECUTIVE DIRECTOR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JASON GRAHAM
BOARD PRESIDENT
4896 HUGH HOWELL ROAD
STONE MOUNTAIN GA 30087

Officer/Director/Trustee Two

KIM FONG
DIRECTOR OF OPERATIONS
4896 HUGH HOWELL ROAD
STONE MOUNTAIN GA 30087

Officer/Director/Trustee Three

LISA KHEMANI
EXECUTIVE DIRECTOR
4896 HUGH HOWELL ROAD
STONE MOUNTAIN GA 30087

Officer/Director/Trustee Four

RUSTY WILLIAMSON
BOARD MEMBER
4896 HUGH HOWELL ROAD
STONE MOUNTAIN GA 30087

Officer/Director/Trustee Five

TIFFANY HELD
BOARD MEMBER
4896 HUGH HOWELL ROAD
STONE MOUNTAIN GA 30087

Organization’s website WWW.SMOKERISEPREP.ORG
Organization’s email INFO@SMOKERISEPREP.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/6/07
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B12 - Fund Raising and/or Fund Distribution
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 Yes
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 LISA KHEMANI
Signature Title EXECUTIVE DIRECTOR
Signature Date 2/7/18

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