FORM 1023-EZ for FREE YOUR SUPERHERO INC

Field Data
EIN 82-1909343
Case Number EO-2017209-000372
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FREE YOUR SUPERHERO INC
Organization’s Mailing Address 901 HOSPITAL DRIVE
City MADIONS
State TN
ZIP 37115
Accounting period End 12
Primary contact name CHRIS BROWN CPA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TODD PASICK
DIRECTOR
901 HOSPITAL
MADISON TN 37115

Officer/Director/Trustee Two

PATRICIA SIEGEL
SECRETARY
5788 SADDLEHORN DRIVE NE
BELMONT MI 49306

Officer/Director/Trustee Three

NATE RENZELLA
TRUSTEE
1013 SMOKE RISE LANE
HENDERSONVILLE TN 37075

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/20/2017
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P80 - Services to Promote the Independence of Specific Populations
Organization’s purpose Charitable: Yes
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 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 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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