FORM 1023-EZ for SHORT MOUNTAIN VOLUNTEER FIRE DEPARTMENT AUXILIARY INC

Field Data
EIN 83-3451180
Case Number EO-2020231-000216
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SHORT MOUNTAIN VOLUNTEER FIRE DEPARTMENT AUXILIARY INC
Organization’s Mailing Address 5 JUDGE PURSER HILL ROAD
City WOODBURY
State TN
ZIP 37190-5323
Accounting period End 12
Primary contact name TIM BELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TIM BELL
PRESIDENT/CEO/CHAIRMAN OF THE BOARD
5 JUDGE PURSER HILL ROAD
WOODBURY TN 37190-5323

Officer/Director/Trustee Two

MICHAEL UNDERHILL
VICE PRESIDENT/VICE CHAIRMAN
5 JUDGE PURSER HILL ROAD
WOODBURY TN 37190-5323

Officer/Director/Trustee Three

CINDY UNDERHILL
CFO/SECRETARY/TREASURER
5 JUDGE PURSER HILL ROAD
WOODBURY TN 37190-5323

Officer/Director/Trustee Four

DWAYNE LAMBERT
BOARD MEMBER AT LARGE
5 JUDGE PURSER HILL ROAD
WOODBURY TN 37190-5323

Officer/Director/Trustee Five

GARRETT JOHNSON
BOARD MEMBER AT LARGE
5 JUDGE PURSER HILL ROAD
WOODBURY TN 37190-5323

Organization’s website
Organization’s email TBELL@CANNONCOUNTYRESCUE.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/8/2019
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code M12 - Fund Raising and/or Fund Distribution
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 TIM BELL
Signature Title PRESIDENT/CEO/CHAIRMAN OF THE BOARD
Signature Date 8/15/2020

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