FORM 1023-EZ for PREMIER OUTREACH FOUNDATION

Field Data
EIN 84-4002818
Case Number EO-2020009-000329
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PREMIER OUTREACH FOUNDATION
Organization’s Mailing Address 2001 MARTIN LUTHER KING JR DR SW
City ATLANTA
State GA
ZIP 30310
Accounting period End 12
Primary contact name AVERY MITCHELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

AVERY MITCHELL
CEO
2001 MARTIN LUTHER KING JR DR SW
ATLANTA GA 30310

Officer/Director/Trustee Two

JIMMY EVANS
SECRETARY
12312 SHERMAN WAY -112
NORTH HOLLYWOOD CA 91605

Officer/Director/Trustee Three

BIANCA MCINTOSH
COMMUNITY LIASON
3206 HELENA SPRINGS AVE APT F
AUGUSTA GA 30909

Officer/Director/Trustee Four

CHRISTY BORDERS
TREASURER
2362 WALNUT TREE LANE
BUFORD GA 30519

Officer/Director/Trustee Five

BELINDA FREEMAN
PRESIDENT
PO BOX 170208
BROOKLYN NY 11217

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/1/2019
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: Yes
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 AVERY MITCHELL
Signature Title CEO
Signature Date 1/7/2020

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