FORM 1023-EZ for SHOP WITH A COP OF BLOUNT COUNTY

Field Data
EIN 82-0611524
Case Number EO-2017067-000599
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SHOP WITH A COP OF BLOUNT COUNTY
Organization’s Mailing Address 940 E LAMAR ALEXANDER PKWY
City MARYVILLE
State TN
ZIP 37804
Accounting period End 12
Primary contact name KAYLA GARRETT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JARROD MILLSAPS
DIRECTOR
940 EAST LAMAR ALEXANDER PKWY
MARYVILLE TN 37804

Officer/Director/Trustee Two

STEVE STILTS
DIRECTOR
3912 SPYGLASS DRIVE
MARYVILLE TN 37801

Officer/Director/Trustee Three

MARIAN OBRIANT
DIRECTOR
940 EAST LAMAR ALEXANDER PKWY
MARYVILLE TN 37804

Officer/Director/Trustee Four

KAYLA GARRETT
DIRECTOR
102 PHEASANT WALK DIVE
MARYVILLE TN 37804

Officer/Director/Trustee Five

STEVEN FLANAGIN
DIRECTOR
811 SAM HOUSTON SCHOOL RD
MARYVILLE TN 37804

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/8/2016
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P30 - Children's, Youth Services
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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