FORM 1023-EZ for COBB COUNTY MEDICAL SOCIETY FOUNDATION

Field Data
EIN 83-3749430
Case Number EO-2019151-000397
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name COBB COUNTY MEDICAL SOCIETY FOUNDATION
Organization’s Mailing Address 114 CHERRY STREET SUITE D
City MARIETTA
State GA
ZIP 30060
Accounting period End 12
Primary contact name JM THURSTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

STAN DYSART MD
PRESIDENT
114 CHERRY ST SUITE D
MARIETTA GA 30060

Officer/Director/Trustee Two

BRETT CANNON MD
PRESIDENT ELECT
114 CHERRY ST SUITE D
MARIETTA GA 30060

Officer/Director/Trustee Three

BRANDY CROSS MD
SECRETARY TREASURER
114 CHERRY ST SUITE D
MARIETTA GA 30060

Officer/Director/Trustee Four

JOANNE THURSTON
EXECUTIVE DIRECTOR
114 CHERRY ST SUITE D
MARIETTA GA 30060

Organization’s website WWW.COBBDOCTORS.ORG
Organization’s email JOANNE.THURSTON@COBBDOCTORS.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/24/19
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T50 - Philanthropy, Charity, Voluntarism Promotion, General
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JOANNE THURSTON
Signature Title EXECUTIVE DIRECTOR
Signature Date 5/29/19

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