FORM 1023-EZ for BROKEN CHAINS INC

Field Data
EIN 90-0641658
Case Number EO-2015093-000354
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BROKEN CHAINS INC
Organization’s Mailing Address PO BOX 91203
City EAST POINT
State GA
ZIP 30364-1203
Accounting period End 12
Primary contact name TONIA BUTTS-GASKIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TONIA BUTTS-GASKIN
CHAIRMAN
4407 ROCHE STREET
COLLEGE PARK GA 30349-1661

Officer/Director/Trustee Two

TARA MILLER
SECRETARY
PO BOX 1128
PALMETTO GA 30268-7128

Officer/Director/Trustee Three

ELISA BASKIN
TREASURER
975 ANVIL WAY
DOUGLASVILLE GA 30134-3624

Organization’s website
Organization’s email BCI.FREEDOM@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/10/2010
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 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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