FORM 1023-EZ for KTHB INC

Field Data
EIN 81-5009498
Case Number EO-2017110-000279
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KTHB INC
Organization’s Mailing Address 4034 TALILUNA AVENUE
City KNOXVILLE
State TN
ZIP 37919
Accounting period End 12
Primary contact name HEATHER BROUSSARD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

WILLIAM PAUL BROUSSARD II
PRESIDENT
4034 TALILUNA AVENUE
KNOXVILLE TN 37919

Officer/Director/Trustee Two

HEATHER BROUSSARD
SECRETARY
4034 TALILUNA AVENUE
KNOXVILLE TN 37919

Officer/Director/Trustee Three

STEVEN BACON
DIRECTOR
1011 NAVAHO ROAD
KNOXVILLE TN 37919

Officer/Director/Trustee Four

BRADLEY SPEARS
DIRECTOR
77 ROLLING LINKS BLVD
OAK RIDGE TN 37830

Organization’s website
Organization’s email BROUSSARD.HEATHER@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/2017
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, N.E.C.
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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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