FORM 1023-EZ for PARKWAY CHRISTIAN AUTOCLUB

Field Data
EIN 81-5371209
Case Number EO-2017135-000232
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PARKWAY CHRISTIAN AUTOCLUB
Organization’s Mailing Address 179 BARNETT RD
City MEDINA
State TN
ZIP 38355
Accounting period End 12
Primary contact name GARY LENTZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GARY LENTZ
SECRETARY-TREASURER
179 BARNETT RD
MEDINA TN 38355

Officer/Director/Trustee Two

GERALD DOUMITT
PRESIDENT
431 LAWRENCE SWITCH RD
JACKSON TN 38305

Officer/Director/Trustee Three

SCOTT KIMPEL
VICE PRESIDENT
1256 PARK RD
HENDERSON TN 38340

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/7/2016
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N50 - Recreational, Pleasure, or Social Club
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
Signature Title
Signature Date

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