FORM 1023-EZ for KIWANIS CLUB OF COOKEVILLE TENNESSEE FOUNDATION INC

Field Data
EIN 47-2266858
Case Number EO-2014314-000180
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KIWANIS CLUB OF COOKEVILLE TENNESSEE FOUNDATION INC
Organization’s Mailing Address 18 NORTH JEFFERSON AVENUE
City COOKEVILLE
State TN
ZIP 38501
Accounting period End 12
Primary contact name JOHN E LANGFORD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

RODLEY PINEDA
PRESIDENT
18 NORTH JEFFERSON AVENUE
COOKEVILLE TN 38501

Officer/Director/Trustee Two

BOB PALMER
VICE-PRESIDENT
18 NORTH JEFFERSON AVENUE
COOKEVILLE TN 38501

Officer/Director/Trustee Three

LARRY VICKERS
SECRETARY
18 NORTH JEFFERSON AVENUE
COOKEVILLE TN 38501

Officer/Director/Trustee Four

TREVOR DYER
TREASURER
18 NORTH JEFFERSON AVENUE
COOKEVILLE TN 38501

Officer/Director/Trustee Five

CHARLES MACKE
BOARD OF DIRECTORS
18 NORTH JEFFERSON AVENUE
COOKEVILLE TN 38501

Organization’s website
Organization’s email LVICKERS@CHARTER.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/1/2013
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W03 - Professional Societies, Associations
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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