FORM 1023-EZ for FRIENDS OF PICKETT STATE PARK INC

Field Data
EIN 45-3625982
Case Number EO-2014318-000310
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FRIENDS OF PICKETT STATE PARK INC
Organization’s Mailing Address 4601 PICKETT PARK HWY
City JAMESTOWN
State TN
ZIP 38556
Accounting period End 12
Primary contact name RON BICKNESE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KEN VON NIEDA
PRESIDENT
4601 PICKETT PARK HWY
JAMESTOWN TN 38556

Officer/Director/Trustee Two

DOYLE NEWBURRY
VICE PRESIDENT
4601 PICKETT PARK HWY
JAMESTOWN TN 38556

Officer/Director/Trustee Three

RON BICKNESE
TREASURER
4601 PICKETT PARK HWY
JAMESTOWN TN 38556

Officer/Director/Trustee Four

CINDY DISHMAN
SECRETARY
4601 PICKETT PARK HWY
JAMESTOWN TN 38556

Officer/Director/Trustee Five

KEITH GARNES
BOARD MEMBER
4601 PICKETT PARK HWY
JAMESTOWN TN 38556

Organization’s website WWW.FRIENDSOFPICKETTSTATEPARK.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/8/2011
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code C30 - Natural Resources Conservation and Protection
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 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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