FORM 1023-EZ for LINCOLN COUNTY SCHOOLS NUTRITION ASSOCIATION

Field Data
EIN 20-5940821
Case Number EO-2018043-000205
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LINCOLN COUNTY SCHOOLS NUTRITION ASSOCIATION
Organization’s Mailing Address 88 SLAUGHTER ROAD
City ARDMORE
State TN
ZIP 38449
Accounting period End 12
Primary contact name DONNA DERRICK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DONNA DERRICK
TREASURER
1649 ARDMORE HWY
TAFT TN 38488

Officer/Director/Trustee Two

MARTHA JOHNSON
PRESIDENT
1233 HUNTSVILLE HWY
FAYETTEVILLE TN 37334

Officer/Director/Trustee Three

CANDI SMITHSON
VICE PRES
111 HIGHLAND RIM RD
FAYETTEVILLE TN 37334

Officer/Director/Trustee Four

SANDRA PATTERSON
SECRETARY
1649 ARDMORE HWY
TAFT TN 38488

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/15/06
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B90 - Educational Services and Schools - Other
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name DONNA DERRICK
Signature Title TREASURER
Signature Date 2/8/18

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