FORM 1023-EZ for KIMBROUGH THEATRE GROUP

Field Data
EIN 82-3564310
Case Number EO-2018064-000159
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KIMBROUGH THEATRE GROUP
Organization’s Mailing Address 11080 VAN BUREN ROAD
City SAULSBURY
State TN
ZIP 38067-8134
Accounting period End 12
Primary contact name LOTTIE KIMBROUGH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LOTTIE KIMBROUGH
PRESIDENT
11080 VAN BUREN ROAD
SAULSBURY TN 38067-8134

Officer/Director/Trustee Two

WINBON KELSEY MASON
VICE PRESIDENT
1363 CHARLES BRYAN ROAD
CORDOVA TN 38018

Officer/Director/Trustee Three

JOHNNIE PEARL HUSSEY
TREASURER
400 BUCK FALL ROAD
GRAND JUNCTION TN 38039

Officer/Director/Trustee Four

JOSEPH RICHARD
SECRETARY
5360 HWY 4 EAST
HOLLY SPRING MS 38635

Officer/Director/Trustee Five

LEVI SMITH
MARKETING DIRECTOR
2330 HIGHWAY 57 EAST
GRAND JUNCTION TN 38039

Organization’s website
Organization’s email KIMBROUGHTHEATRE @GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/29/17
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A70 - Humanities Organizations
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: Yes
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 LOTTIE KIMBROUGH
Signature Title PRESIDENT
Signature Date 3/1/18

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