FORM 1023-EZ for STEWART COUNTY HEALTHY SCHOOLS COMMUNITY FOUNDATION
| Field | Data |
|---|---|
| EIN | 81-3707911 |
| Case Number | EO-2017069-000272 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | STEWART COUNTY HEALTHY SCHOOLS COMMUNITY FOUNDATION |
| Organization’s Mailing Address | 110 NATCOR DRIVE - PO BOX 367 |
| City | DOVER |
| State | TN |
| ZIP | 37058-4500 |
| Accounting period End | 12 |
| Primary contact name | LYNNE BUTKIEWICZ |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
ELAINE JACKSON
REGISTERED AGENT
239 WYNNS FERRY RD
DOVER TN 37058-4500
Officer/Director/Trustee Two
LYNNE BUTKIEWICZ
SECRETARY
107 RACCOON CIRCLE
DOVER TN 37058
Officer/Director/Trustee Three
DAVID HICKS
PRESIDENT
161 SHADY REST LANE
DOVER TN 37058
Officer/Director/Trustee Four
MARGIE SMITH
TREASURER
760 COTTRELL RIDGE RD
DOVER
Officer/Director/Trustee Five
RICKIE JOINER
BOARD OF DIRECTOR
206 JONIER HOLLOW RD
BIG ROCK TN 30723
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 8/30/2016 |
| Organization Incorporation State | TN |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | E80 - Health, General and Financing |
| Organization’s purpose | Charitable: Yes Religious: No Educational: Yes Scientific: No Literary: Yes Public Safety: No Amateur Sports: No Cruelty Prevention: Yes |
| 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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