FORM 1023-EZ for THE CITY OF REFUGE KIDS CLUB

Field Data
EIN 81-1615574
Case Number EO-2018232-000418
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE CITY OF REFUGE KIDS CLUB
Organization’s Mailing Address 428 CLAIRCREST DR
City ANTIOCH
State TN
ZIP 37013
Accounting period End 12
Primary contact name KELCY MORRIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CURTIS ALEXANDER
PRESIDENT/ BOARD MEMBER
428 CLAIRCREST DRIVE
ANTIOCH TN 37013

Officer/Director/Trustee Two

LASHUNDA YOUNG
SECRETARY/BOARD MEMBER
4141 PLEASANT COLONY DRIVE
ANTIOCH TN 37013

Officer/Director/Trustee Three

KARLA SCOTT
BOARD MEMBER
PO BOX 290432
NASHVILLE TN 37229

Officer/Director/Trustee Four

SHARITA MCKISSACK
BOARD MEMBER
4163 FARMVIEW DRIVE
NASHVILLE TN 37218

Officer/Director/Trustee Five

CORA LINDA ALEXANDER
BOARD MEMBER
209 CIRCLE VIEW DRIVE
FRANKLIN TN 37067

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/28/16
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: Yes
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name CURTIS ALEXANDER
Signature Title PRESIDENT/ BOARD MEMBER
Signature Date 8/17/18

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