FORM 1023-EZ for MARSHALL COUNTY CANCER FOUNDATION

Field Data
EIN 81-3555696
Case Number EO-2017012-000351
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MARSHALL COUNTY CANCER FOUNDATION
Organization’s Mailing Address PO BOX 82
City BELFAST
State TN
ZIP 37019
Accounting period End 12
Primary contact name TRINA RIOS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TRINA RIOS
PRESIDENT
250 DAYTONA DRIVE
CORNERSVILLE TN 37047

Officer/Director/Trustee Two

CHRISTA CRAWFORD
GRANT CHAIR
2420 MT LEBANON ROAD
LEWISBURG TN 37091

Officer/Director/Trustee Three

EMILY YOUNG
FUNDRAISING CO-CHAIR
2655 MOORESVILLE HWY
LEWISBURG TN 37091

Officer/Director/Trustee Four

MISTY BEARD
FUNDRAISING CO-CHAIR
2421 OLD FARMINGTON ROAD
LEWISBURG TN 37091

Officer/Director/Trustee Five

LISA STEELY
VICE PRESIDENT
2300 CEDAR BROOK LANE
LEWISBURG TN 37091

Organization’s website WWW.MARSHALLCANCERFOUNDATION.ORG
Organization’s email MCCANCERFOUNDATION@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/24/2016
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T12 - 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 Yes
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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