FORM 1023-EZ for FORSYTH COUNTY LIONS CHARITIES INC

Field Data
EIN 81-4431587
Case Number EO-2016330-000325
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FORSYTH COUNTY LIONS CHARITIES INC
Organization’s Mailing Address PO BOX 1317
City CUMMING
State GA
ZIP 30028-1317
Accounting period End 12
Primary contact name LARRY SHELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NANCY HUTCHEON
PRESIDENT, DIRECTOR
4450 DELANO DR
CUMMING GA 30040

Officer/Director/Trustee Two

LARRY SHELL
SECRETARY, DIRECTOR
4890 HEATHCLIFF WAY
CUMMING GA 30041

Officer/Director/Trustee Three

DAVID BRIGHTMAN
TREASURER, DIRECTOR
4315 HUNTERS WALK WAY
CUMMING GA 30028

Officer/Director/Trustee Four

DIANE O SHIELDS
DIRECTOR
421 BEAVER RUN RD
BALLGROUND GA 30107

Officer/Director/Trustee Five

STEVE WILLIAMS
DIRECTOR
PO BOX 1002
ALPHARETTA GA 30009

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/10/2016
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 No
Donation of funds Yes
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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