FORM 1023-EZ for TN SOCIAL INNOVATION FUND

Field Data
EIN 84-1868808
Case Number EO-2019297-000257
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TN SOCIAL INNOVATION FUND
Organization’s Mailing Address 41 PEABODY STREET
City NASHVILLE
State TN
ZIP 37210
Accounting period End 12
Primary contact name MARK EATHERLY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARK EATHERLY
PRESIDENT
41 PEABODY STREET
NASHVILLE TN 37210

Officer/Director/Trustee Two

IRENE CLARK
CHAIR
41 PEABODY STREET
NASHVILLE TN 37210

Officer/Director/Trustee Three

DONNA DOUGHERTY
SECRETARY
41 PEABODY STREET
NASHVILLE TN 37210

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/23/19
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name MARK EATHERLY
Signature Title PRESIDENT
Signature Date 10/19/19

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