FORM 1023-EZ for CHEATHAM RECOVERY HOUSE

Field Data
EIN 47-3410026
Case Number EO-2015082-000305
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CHEATHAM RECOVERY HOUSE
Organization’s Mailing Address 108 CUMBERLAND ST
City ASHLAND CITY
State TN
ZIP 37015-1102
Accounting period End 12
Primary contact name PAMELA THOMAS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

PAMELA THOMAS
DIRECTOR
103 LOWE STREET
ASHLAND CITY TN 37015-1102

Officer/Director/Trustee Two

ELLIE AMBROSE
SECRATERY
1458 INDIAN SPRINGS ROAD
PEGRAM TN 37143-5054

Officer/Director/Trustee Three

RIDLEY WYATT
TREASURER
100 TUCKER STREET
ASHLAND CITY TN 37015-2011

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/26/2015
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F22 - Alcohol, Drug Abuse, Treatment Only
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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
Signature Title
Signature Date

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