FORM 1023-EZ for CAMERON BEAN MEMORIAL INC

Field Data
EIN 47-5358309
Case Number EO-2016057-000116
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CAMERON BEAN MEMORIAL INC
Organization’s Mailing Address 3846 HEARTHSTONE CIRCLE
City CHATTANOOGA
State TN
ZIP 37415
Accounting period End 12
Primary contact name STEVE BEAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

STEVE BEAN
DIRECTOR
2236 DRIFTWOOD ROAD
SODDY DAISY TN 37379

Officer/Director/Trustee Two

LISA BEAN
DIRECTOR
2236 DRIFTWOOD ROAD
SODDY DAISY TN 37379

Officer/Director/Trustee Three

OLIVER TOWNSEND
DIRECTOR
301 ELIZABETH STREET APT 11B
NEW YORK NY 10012

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/15/2015
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 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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