FORM 1023-EZ for TEAM EVAN PEDIATRIC STROKE SURVIVORS
| Field | Data |
|---|---|
| EIN | 47-1969938 |
| Case Number | EO-2020071-000386 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | TEAM EVAN PEDIATRIC STROKE SURVIVORS |
| Organization’s Mailing Address | 505 NICKAJACK LANDING |
| City | SOUTH PITTSBURG |
| State | TN |
| ZIP | 37380 |
| Accounting period End | 12 |
| Primary contact name | MICHELLE JOHNSON |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
MICHELLE JOHNSON
PRESIDENT AND CEO
505 NICKAJACK LANDING
SOUTH PITTSBURG TN 37380
Officer/Director/Trustee Two
PHILLIP CERRILLO
VICE PRESIDENT
705 CORNERSTONE COURT
EVANS GA 30809
Officer/Director/Trustee Three
KEVIN SMITH
EXECUTIVE DIRECTOR
501 VALLEY LANE
PITTSBORO NC 37312
Officer/Director/Trustee Four
CRAIG SMITH
TREASURER
601 PARK DRIVE
GOODLETTSVILLE TN 37072
Officer/Director/Trustee Five
MICHELLE WEST
SECRETARY
235 BRUCE LANE
BREMEN KY 42325
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | No |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 1/25/2016 |
| Organization Incorporation State | TN |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | P01 - Alliance/Advocacy Organizations |
| 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 | Yes |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | MICHELLE JOHNSON |
| Signature Title | PRESIDENT AND CEO |
| Signature Date | 3/9/2020 |
| EIN | 47-1969938 |
| Case Number | EO-2016201-000409 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | TEAM EVAN PEDIATRIC STROKE SURVIVORS |
| Organization’s Mailing Address | 3131 MOUNTAIN CREEK ROAD APT 13B7 |
| City | CHATTANOOGA |
| State | TN |
| ZIP | 37415 |
| Accounting period End | 12 |
| Primary contact name | MICHELLE JOHNSON |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
MICHELLE JOHNSON
PRESIDENT AND CEO
3131 MOUNTAIN CREEK ROAD APT 13B7
CHATTANOOGA TN 37415
Officer/Director/Trustee Two
PHILLIP CERRILLO
VICE PRESIDENT
318 GOLDFINCH DRIVE
AUGUSTA GA 30907
Officer/Director/Trustee Three
KEVIN SMITH
EXECUTIVE DIRECTOR
501 VALLEY LANE
PITTSBORO NC 37312
Officer/Director/Trustee Four
CRAIG SMITH
TREASURER
609 PARK DRIVE
GOODLETTSVILLE TN 37072
Officer/Director/Trustee Five
MICHELLE WEST
SECRETARY
235 BRUCE LANE
BREMEN KY 42325
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | No |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 1/25/2016 |
| Organization Incorporation State | TN |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | P01 - Alliance/Advocacy Organizations |
| 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 | |
| Signature Title | |
| Signature Date |
Recently Saved Organizations
Click on the save icon from a search results or organization page.
