FORM 1023-EZ for THE ROLLINS FAMILY FOUNDATION

Field Data
EIN 47-4029232
Case Number EO-2016020-000343
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE ROLLINS FAMILY FOUNDATION
Organization’s Mailing Address 1211 16TH AVENUE SOUTH
City NASHVILLE
State TN
ZIP 37212-2901
Accounting period End 12
Primary contact name NORMAN ROLLINS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

NORMAN ROLLINS
DIRECTOR/PRESIDENT
3137 KNOBVIEW DRIVE
NASHVILLE TN 37214

Officer/Director/Trustee Two

JEFF ROLLINS
DIRECTOR/SECRETARY
3309 PINE CIRCLE
OCEAN SPRINGS MS 39564

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/8/2015
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T22 - Private Independent Foundations
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 Yes
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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