FORM 1023-EZ for INTEGRATIVE OUTREACH INC

Field Data
EIN 82-4006144
Case Number EO-2018295-000346
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name INTEGRATIVE OUTREACH INC
Organization’s Mailing Address 912 W BROADWAY AVE
City MARYVILLE
State TN
ZIP 37801
Accounting period End 12
Primary contact name JESSICA BAILEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GAYLE OWENS
PRESIDENT
244 JONES BEND ROAD
LOUISVILLE TN 37777

Officer/Director/Trustee Two

TED BURKHALTER JR
SECRETARY
PO BOX 5255
MARYVILLE TN 37802

Officer/Director/Trustee Three

LILLA MAE KING
BOARD MEMBER
4411 GREENFERN WAY
KNOXVILLE TN 37912

Officer/Director/Trustee Four

LEONARD ERNEST RHEAULT
BOARD MEMBER
181 FOXGLEN LANE
ANDERSONVILLE TN 37705

Officer/Director/Trustee Five

CLAYTON WAGNER BELL
BOARD MEMBER
1600 SAILMAKER WAY APT 301
KNOXVILLE TN 37920

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/15/18
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E99 - Health - General and Rehabilitative N.E.C.
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name TED BURKHALTER JR
Signature Title SECRETARY
Signature Date 10/19/18

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