FORM 1023-EZ for SOUTHEASTERN REGION LEGACY OF LIGHTFOUNDATION INC

Field Data
EIN 84-1817770
Case Number EO-2019238-000741
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SOUTHEASTERN REGION LEGACY OF LIGHTFOUNDATION INC
Organization’s Mailing Address 215 CAMELOT DRIVE
City DUBLIN
State GA
ZIP 31021
Accounting period End 6
Primary contact name AYANI GOOD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAKIMVA MARTIN
PRESIDENT
215 CAMELOT DRIVE
DUBLIN GA 31201

Officer/Director/Trustee Two

LUVOB BROWN
SECRETARY
3333 OLD SALEM ROAD
CONYERS GA 30013

Officer/Director/Trustee Three

JACQUENETTE LAWRENCE
TREASURER
706 DAWN STREET
BEAUFORT SC 29906

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/7/19
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A65 - Theater
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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 No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JAKIMVA MARTIN
Signature Title PRESIDENT
Signature Date 8/24/19

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