FORM 1023-EZ for SAINT FRANCIS HOSPITAL - BARTLETT AUXILARY

Field Data
EIN 47-1403476
Case Number EO-2014353-000238
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SAINT FRANCIS HOSPITAL - BARTLETT AUXILARY
Organization’s Mailing Address 2986 KATE BOND RD
City BARTLETT
State TN
ZIP 38133-4003
Accounting period End 12
Primary contact name JANE GARRETT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CAROLYN BORDEN
PRESIDENT
3616 APPLING LAKE
BARTLETT TN 38133-4003

Officer/Director/Trustee Two

SUSAN COLLINS
VICE-PRESIDENT
110 BONNE TERRE CV
EADS TN 38028-3003

Officer/Director/Trustee Three

SHARON COLLINS
VICE-PRESIDENT
2549 SURREY WOODS DR
BARTLETT TN 38134-4003

Officer/Director/Trustee Four

RICHARD COBB
TREASURER
5766 PINOLA AVE
BARTLETT TN 38134-4003

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/23/2014
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E20 - Hospitals and Related Primary Medical Care Facilities
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 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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