FORM 1023-EZ for TELLICO LAKE ROTARY FOUNDATION

Field Data
EIN 35-2523367
Case Number EO-2015013-000129
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TELLICO LAKE ROTARY FOUNDATION
Organization’s Mailing Address PO BOX 64
City VONORE
State TN
ZIP 37885
Accounting period End 6
Primary contact name DAVID FOOTE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SUSAN EVERSON
PRESIDENT
124 NADULI TRAIL
VONORE TN 37885

Officer/Director/Trustee Two

JAMES DECKER
VICE-PRESIDENT
129 EDATA TRAIL
VONORE TN 37885

Officer/Director/Trustee Three

THOMAS BANTEL
SECRETARY
308 OKMULGEE CIRCLE
LOUDON TN 37774

Officer/Director/Trustee Four

DAVID FOOTE
TREASURER
310 PINEBERRY DRIVE
VONORE TN 37885-5321

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/5/2013
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Y12 - 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 Yes
One Third Support Gifts No
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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