FORM 1023-EZ for DONT COUNT ME OUT INC

Field Data
EIN 81-4418560
Case Number EO-2019345-000413
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DONT COUNT ME OUT INC
Organization’s Mailing Address 2401 WEATHERSTONE CIRCLE
City CONYERS
State GA
ZIP 30094
Accounting period End 12
Primary contact name MATTIE JAMES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MATTIE JAMES
CHAIRBOARD
2401 WEATHERSTONE CIRCLE
CONYERS GA 30094

Officer/Director/Trustee Two

AMBER TWITTY
VICE CHAIR
3635 SOLAR VISTA PL
CINCINNATI OH 45216

Officer/Director/Trustee Three

TERESA WATSON
SECRETARY
300 PEACHTREE
ATLANTA GA 30308

Officer/Director/Trustee Four

KARLIXLE WINCHESTER
TREASURER
47 IVAN ALLEN JR
ATLANTA GA 30308

Officer/Director/Trustee Five

MICHELLE MERRETT
PARLIAMENTARIAN
1000 MAIN STREET
HAMILTON OH 45011

Organization’s website DONTCOUNTMEOUTUSA.ORG
Organization’s email DCMO@DONTCOUNTMEOUTUSA.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/19/2016
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P40 - Family Services
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name MATTIE JAMES
Signature Title CHAIRBOARD
Signature Date 12/9/2019
EIN 81-4418560
Case Number EO-2017075-000262
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DONT COUNT ME OUT INC
Organization’s Mailing Address 2401 WEATHERSTONE CIRCLE
City CONYERS
State GA
ZIP 30094
Accounting period End 12
Primary contact name MONIQUE JAMES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MONIQUE JAMES
CHAIRMAN
2401 WEATHERSTONE CIRCLE
CONYERS GA 30094

Officer/Director/Trustee Two

DONALD NOBLE
VICE CHAIRMAN
2401 WEATHERSTONE CIRCLE
CONYERS GA 30094

Officer/Director/Trustee Three

AMBER TWITTY
TREASURER
2401 WEATHERSTONE CIRCLE
CONYERS GA 30094

Officer/Director/Trustee Four

LORI DAVIS
SECRETARY
2401 WEATHERSTONE CIRCLE
CONYERS GA 30094

Officer/Director/Trustee Five

CLAUDIA FOLLETT
PARLIAMENTARIAN
2401 WEATHERSTONE CIRCLE
CONYERS GA 30094

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/19/2016
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P40 - Family Services
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 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 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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