FORM 1023-EZ for GRUNDY ROTARY SERVICE FUND REINSTATEMENT

Field Data
EIN 27-0610603
Case Number EO-2015069-000162
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name GRUNDY ROTARY SERVICE FUND REINSTATEMENT
Organization’s Mailing Address PO BOX 585
City MONTEAGLE
State TN
ZIP 37356-0585
Accounting period End 12
Primary contact name JAMES E WALLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JAMES WALLER
PRESIDENT
PO BOX 585
MONTEAGLE TN 37356-0585

Officer/Director/Trustee Two

HENRY CHASE
TREASURER
PO BOX 1327
MONTEAGLE TN 37356-1327

Officer/Director/Trustee Three

HOWELL ADAMS
VICE PRESIDENT
3750 PEACHTREE ROAD NE
ATLANTA GA 30319-1200

Officer/Director/Trustee Four

ANN BRADLEY
SECRETARY
PO BOX 1175
MONTEAGLE TN 37356-1175

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/14/2009
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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