FORM 1023-EZ for FRIENDS OF THE LEWIS COUNTY PUBLICLIBRARY

Field Data
EIN 58-1606773
Case Number EO-2019031-000135
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FRIENDS OF THE LEWIS COUNTY PUBLICLIBRARY
Organization’s Mailing Address 15 KYLE AVENUE
City HOHENWALD
State TN
ZIP 38462
Accounting period End 4
Primary contact name GLENA SIKES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GLENA SIKES
CHAIR
107 DENICOLAS DRIVE
HOHENWALD TN 38462

Officer/Director/Trustee Two

KELLY MEDFORD
SECRETARY
4503 SWAN CREEK ROAD
CENTERVILLE TN 37033

Officer/Director/Trustee Three

MICHELLE JONES
TREASURER
138 WINDSWEPT LANE
HOHENWALD TN 38462

Officer/Director/Trustee Four

JUDY BRYSON
MEMBER AT LARGE
1054 CINDY LANE
HOHENWALD TN 38462

Officer/Director/Trustee Five

KATHRYN KOZLINSKI
MEMBER AT LARGE
105 HUBBARD STREET
HOHENWALD TN 38462

Organization’s website
Organization’s email LEWISCOUNTYFOTL@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/8/10
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B70 - Libraries
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name KELLY MEDFORD
Signature Title SECRETARY
Signature Date 1/3/19
EIN 58-1606773
Case Number EO-2019031-000135
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FRIENDS OF THE LEWIS COUNTY PUBLIC LIBRARY
Organization’s Mailing Address 15 KYLE AVENUE
City HOHENWALD
State TN
ZIP 38462
Accounting period End 4
Primary contact name GLENA SIKES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GLENA SIKES
CHAIR
107 DENICOLAS DRIVE
HOHENWALD TN 38462

Officer/Director/Trustee Two

KELLY MEDFORD
SECRETARY
4503 SWAN CREEK ROAD
CENTERVILLE TN 37033

Officer/Director/Trustee Three

MICHELLE JONES
TREASURER
138 WINDSWEPT LANE
HOHENWALD TN 38462

Officer/Director/Trustee Four

JUDY BRYSON
MEMBER AT LARGE
1054 CINDY LANE
HOHENWALD TN 38462

Officer/Director/Trustee Five

KATHRYN KOZLINSKI
MEMBER AT LARGE
105 HUBBARD STREET
HOHENWALD TN 38462

Organization’s website
Organization’s email LEWISCOUNTYFOTL@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/8/10
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B70 - Libraries
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name KELLY MEDFORD
Signature Title SECRETARY
Signature Date 1/3/19

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