FORM 1023-EZ for ASTUTE CREDIT REHAB

Field Data
EIN 82-4571427
Case Number EO-2018095-000626
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ASTUTE CREDIT REHAB
Organization’s Mailing Address 5726 MARLIN ROAD SUITE 314
City CHATTANOOGA
State TN
ZIP 37411
Accounting period End 12
Primary contact name DONNA BLAKEMORE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SAMUEL BLAKEMORE
PRES / TREASURER
5726 MARLIN ROAD SUITE 314
CHATTANOOGA TN 37411

Officer/Director/Trustee Two

DONNA BLAKEMORE
VICE PRES / SECRETARY
5726 MARLIN ROAD SUITE 314
CHATTANOOGA TN 37411

Officer/Director/Trustee Three

JOAN CAMPBELL
DIRECTOR
737 EAST 10TH ST
CHATTANOOGA TN 37403

Officer/Director/Trustee Four

WILEY MORTON
DIRECTOR
8413 OAK DRIVE
CHATTANOOGA TN 37421

Officer/Director/Trustee Five

LLOYD LEVITT
DIRECTOR
312 VINE STREET
CHATTANOOGA TN 37403

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/27/18
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W99 - Public, Society Benefit - Multipurpose and Other N.E.C.
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 Yes
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 SAMUEL BLAKEMORE
Signature Title PRES / TREASURER
Signature Date 3/22/18

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