FORM 1023-EZ for PROSTATE RESOURCE FOUNDATION

Field Data
EIN 81-2580743
Case Number EO-2021032-000132
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PROSTATE RESOURCE FOUNDATION
Organization’s Mailing Address 191 CHESTNUT STREET SUITE 201
City CHATTANOOGA
State TN
ZIP 37402
Accounting period End 12
Primary contact name KATHY BUSCH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KATHY BUSCH
PRESIDENT
191 CHESTNUT STREET SUITE 201
CHATTANOOGA TN 37402

Officer/Director/Trustee Two

DIANE WOLFORD
SECRETARY/TREASURER
412 GEORGIA AVENUE
CHATTANOOGA TN 37403

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/5/2016
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G30 - Cancer
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee Yes
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers Yes
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name KATHY BUSCH
Signature Title PRESIDENT
Signature Date 12/15/2020

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