FORM 1023-EZ for FREE WILL SHELTER AND OUTREACH

Field Data
EIN 33-1100066
Case Number EO-2018236-000308
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FREE WILL SHELTER AND OUTREACH
Organization’s Mailing Address 289
City HUMBOLDT
State TN
ZIP 38343-289
Accounting period End 12
Primary contact name DOROTHY FARNER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ESSIE BARNES
EXECUTIVE DIRECTOR
1519 MITCHELL
HUMBOLDT TN 38343

Officer/Director/Trustee Two

ELROY HICKS
CHAIRMAN
1006 MCLIN EXT
HUMBOLDT TN 38343

Officer/Director/Trustee Three

DOROTHY FARNER
ASSISTANT DIRECTOR
508 MOCKINGBIRD
HUMBOLDT TN 38343

Officer/Director/Trustee Four

ORA WOOLFORD
SECRETARY
2814 CENTRAL AVE
HUMBOLDT TN 38343

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/18/04
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
Organization’s purpose Charitable: Yes
Religious: Yes
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name DOROTHY FARNER
Signature Title ASSISTANT DIRECTOR
Signature Date 8/22/18

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