FORM 1023-EZ for SOUTH ENOTAH CHILD ADVOCACY CENTERINC

Field Data
EIN 81-3158790
Case Number EO-2016193-000262
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SOUTH ENOTAH CHILD ADVOCACY CENTERINC
Organization’s Mailing Address PO BOX 1145
City DAHLONEGA
State GA
ZIP 30533
Accounting period End 6
Primary contact name ANDY CHAMBERS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANDY CHAMBERS
VICE PRESIDENT - DIRECTOR
490 MAPLE STREET
CORNELIA GA 30531

Officer/Director/Trustee Two

CHEYENNE THORNTON
PRESIDENT - DIRECTOR
385 EAST MAIN STREET
DAHLONEGA GA 30533

Officer/Director/Trustee Three

SUSAN HURLEY
TREASURER - DIRECTOR
275 BENT RIDGE DRIVE N
DAWSONVILLE GA 30534

Officer/Director/Trustee Four

BRIGETTE BARKER
SECRETARY - DIRECTOR
59 INDIAN DRIVE
DAHLONEGA GA 30533

Officer/Director/Trustee Five

MARK GRIFFITH
DIRECTOR
45 FOX HUNTER LANE
CLEVELAND GA 30528

Organization’s website
Organization’s email CHEYENNE.THORNTON@LUMPKINCOUNTY.GOV
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/1/2016
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F42 - Rape Victim Services
Organization’s purpose Charitable: No
Religious: No
Educational: No
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 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
Signature Title
Signature Date

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