FORM 1023-EZ for LAURA BELL GLOVER-ANDERSON HOMELESSSUPPORT AGENCY INC

Field Data
EIN 87-1123203
Case Number EO-2021183-000373
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LAURA BELL GLOVER-ANDERSON HOMELESSSUPPORT AGENCY INC
Organization’s Mailing Address 506 JOHNSTOWN DRIVE
City SMYRNA
State TN
ZIP 37167
Accounting period End 12
Primary contact name LARRY GLOVER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LARRY GLOVER
CEO
506 JOHNSTOWN DRIVE
SMYRNA TN 37167

Officer/Director/Trustee Two

PATRICIA FORD
TREASURER
2405 BATTLE CREEK VILLAGE DRIVE
JONESBORO GA 30236

Officer/Director/Trustee Three

KIMBERLY JACKSON-ROME
OFFICER
4059 RHODES AVENUE
MEMPHIS TN 38111

Officer/Director/Trustee Four

JOHN ANDERSON
DIRECTOR
3360 SPRING SHADOW DRIVE
MEMPHIS TN 38118

Officer/Director/Trustee Five

CHELSEA GLOVER
DIRECTOR
3355 BLACKBURN STREET 4101
DALLAS TX 75204

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/9/2021
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P85 - Homeless Persons Centers, Services
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 Yes
Donation of funds Yes
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 Yes
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 LARRY GLOVER
Signature Title CEO
Signature Date 6/29/2021

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