FORM 1023-EZ for CORY NICKOLS MINISTRIES INC

Field Data
EIN 85-2920429
Case Number EO-2021019-000079
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CORY NICKOLS MINISTRIES INC
Organization’s Mailing Address 77 12TH ST NE UNIT 2202
City ATLANTA
State GA
ZIP 30309
Accounting period End 12
Primary contact name CORY NICKOLS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BART SHAW
DIRECTOR
12785 DEVON LN
CARMEL IN 46032

Officer/Director/Trustee Two

NATE ROBINSON
DIRECTOR - TREASURER
13405 MORNING MIST PL
PLAINFIELD IL 60585

Officer/Director/Trustee Three

TROY WIELAND
DIRECTOR - SECRETARY
15004 SR 1
LEO IN 46765

Officer/Director/Trustee Four

TYLER NICKOLS
DIRECTOR
4940 COUNTY RD 43
AUBURN IN 46706

Officer/Director/Trustee Five

CORY NICKOLS
PRESIDENT - CEO/ EXECUTIVE DIRECTOR
77 12TH ST NE UNIT 2202
ATLANT GA 30309

Organization’s website WWW.CORYNICKOLS.COM
Organization’s email CORY@CORYNICKOLS.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/9/2020
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: No
Religious: Yes
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 Yes
Donation of funds No
Conducting Activities Outside of United States Yes
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 No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name CORY NICKOLS
Signature Title PRESIDENT - CEO/ EXECUTIVE DIRECTOR
Signature Date 11/25/2020

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