FORM 1023-EZ for WASHBURN SENIOR CITIZENS

Field Data
EIN 47-1636662
Case Number EO-2014234-000299
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name WASHBURN SENIOR CITIZENS
Organization’s Mailing Address 2999 HIGHWAY 131
City WASHBURN
State TN
ZIP 37888
Accounting period End 12
Primary contact name JANET FOWLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JANET FOWLER
PRESIDENT
2999 HIGHWAY 131
WASHBURN TN 37708

Officer/Director/Trustee Two

KATHY MORGAN
VICE PRESIDENT
133 ROGERS STREET
RUTLEDGE TN 37861

Officer/Director/Trustee Three

LARRY YARNELL
SECRETARY
2843 HIGHWAY 131
WASHBURN TN 37888

Officer/Director/Trustee Four

SHARON GARRIDO
TREASURER
10816 HIGHWAY 131
WASHBURN TN 37888

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/1/2013
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W24 - Citizen Participation
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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