FORM 1023-EZ for STATION CAMP-MERROL HYDE SWIM CLUB

Field Data
EIN 83-2394943
Case Number EO-2019037-000408
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name STATION CAMP-MERROL HYDE SWIM CLUB
Organization’s Mailing Address 1010 DILLON LANE
City GALLATIN
State TN
ZIP 37066
Accounting period End 5
Primary contact name KATHY AUSDERAU
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GINA PEARSON
PRESIDENT
1010 DILLON LANE
GALLATIN TN 37066

Officer/Director/Trustee Two

KATHY AUSDERAU
VICE PRESIDENT
115 HIGGINSON PL N
GALLATIN TN 37066

Officer/Director/Trustee Three

ANNIE KOCH
SECRETARY
236 CHEROKEE ROAD
HENDERSONVILLE TN 37075-6719

Officer/Director/Trustee Four

NICOLE RUSSELL
TREASURER
175 WYNBROOKE TRACE
HENDERSONVILLE TN 37075-6719

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/16/18
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B11 - Single Organization Support
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 KATHY AUSDERAU
Signature Title VICE PRESIDENT
Signature Date 1/1/19

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