FORM 1023-EZ for Q EXCLUSIVE INCORPORATION

Field Data
EIN 90-0615410
Case Number EO-2014337-000303
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name Q EXCLUSIVE INCORPORATION
Organization’s Mailing Address 200 CARRINGTON LANE
City CENTERVILLE
State GA
ZIP 31028
Accounting period End 12
Primary contact name MARSHEILA TILLMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DEL TURNER
PRESIDENT
718 GREEN STREET APT A-201
FORT VALLEY GA 31030

Officer/Director/Trustee Two

MARSHEILA TILLMAN
CHIEF EXECUTIVE OFFICER
200 CARRINGTON LANE
CENTERVILLE GA 31028

Officer/Director/Trustee Three

LAKEESHA BLASINGAME
SECRETARY
270 LAKESHORE DRIVE
WARNER ROBINS GA 31088

Officer/Director/Trustee Four

EARL TILLMAN
CHIEF FINANCIAL OFFICER
200 CARRINGTON LANE
CENTERVILLE GA 31028

Officer/Director/Trustee Five

YOLANDA MCDONALD
ADMINSTRATIVE ASSISTANT
106 DENEED DRIVE
FORT VALLEY GA 31030

Organization’s website WWW.QEXCLUSIVEINC.ORG
Organization’s email QEXCLUSIVEINC@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/27/2010
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 Yes
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 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
Signature Title
Signature Date

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