FORM 1023-EZ for ASPHALT ANGELS

Field Data
EIN 46-1305596
Case Number EO-2015111-000043
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ASPHALT ANGELS
Organization’s Mailing Address 2718 GREER ROAD
City GOODLETTSVILLE
State TN
ZIP 37072
Accounting period End 3
Primary contact name ALEXANDER KOZLOWSKI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ALEXANDER KOZLOWSKI
PRESIDENT
2718 GREER RD
GOODLETTSVILLE TN 37072

Officer/Director/Trustee Two

JENNIFER KOZLOWSKI
SECRETARY
2718 GREER RD
GOODLETTSVILLE TN 37072

Officer/Director/Trustee Three

MARK BROWNELL
DIRECTOR
2718 GREER RD
GOODLETTSVILLE TN 37072

Organization’s website WWW.ASPHALTANGELS2012.COM
Organization’s email ASPHALTANGELS2012@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/17/2014
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G98 - Pediatrics
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 Yes
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 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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