FORM 1023-EZ for CUMBERLAND GAP

Field Data
EIN 81-3521203
Case Number EO-2016250-000142
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CUMBERLAND GAP
Organization’s Mailing Address 1008 LINCOLN RD
City JAMESTOWN
State TN
ZIP 38556-6079
Accounting period End 10
Primary contact name LESLEY HOLT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LESLEY HOLT
PRESIDENT
1008 LINCOLN RD
JAMESTOWN TN 38556-6079

Officer/Director/Trustee Two

AUDRA CHINN
SECRETARY
135 SARAH BETH DR
JAMESTOWN TN 38556-6907

Officer/Director/Trustee Three

MICAH DUNFORD
VICE PRESIDENT
1372 OWENS RD
JAMESTOWN TN 38556-5480

Officer/Director/Trustee Four

TERRY THOMPSON
TRUSTEE
170 STEPP RD
CLARKRANGE TN 38553-5200

Officer/Director/Trustee Five

ROGER BURKS
TRUSTEE
124 GALLAHER LN
CLARKRANGE TN 38553-5361

Organization’s website
Organization’s email CUMBERLANDGAPEMAIL@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/2/2016
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L81 - Home Improvement and Repairs
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 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
Signature Title
Signature Date

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