FORM 1023-EZ for THE PHOENIX MUSCULAR DYSTROPHY INC

Field Data
EIN 46-3965651
Case Number EO-2018089-000267
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE PHOENIX MUSCULAR DYSTROPHY INC
Organization’s Mailing Address 3294 BOBBIE LANE
City DECATUR
State GA
ZIP 30032
Accounting period End 12
Primary contact name DANIELLE WHITE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DANIELLE WHITE
PRESIDENT
3294 BOBBIE LANE
DECATUR GA 30032

Officer/Director/Trustee Two

TERRY WHITE
VICE PRESIDENT
3294 BOBBIE LANE
DECATUR GA 30032

Officer/Director/Trustee Three

SHEMIKA WALLACE
EXECUTIVE DIRECTOR
3294 BOBBIE LANE
DECATUR GA 30032

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/12/13
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E11 - Single Organization Support
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 Yes
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
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 DANIELLE WHITE
Signature Title PRESIDENT
Signature Date 3/28/18

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