FORM 1023-EZ for FINISH LINE ADAPTIVE INC

Field Data
EIN 83-4307536
Case Number EO-2019136-000335
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FINISH LINE ADAPTIVE INC
Organization’s Mailing Address 4 KING PHILIP WAY
City EAST FREETOWN
State MA
ZIP 2717-1034
Accounting period End 12
Primary contact name ELLEN LUBELL ESQ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TAMMY JEROME
PRESIDENT
52 CIDER MILL RD
BEDFORD NH 3110-4409

Officer/Director/Trustee Two

KIM ALEXANDER
VICE PRESIDENT
460 HUNTCLIFF GREEN
ATLANTA GA 30350-2604

Officer/Director/Trustee Three

MICHELLE BRAGA
TREASURER - CLERK
4 KING PHILIP WAY
EAST FREETOWN MA 2717-1034

Officer/Director/Trustee Four

TAMMY JEROME
DIRECTOR
52 CIDER MILL RD
BEDFORD NH 3110-4409

Organization’s website WWW.FINISHLINEADAPTIVE.ORG
Organization’s email FINISHLINEADAPTIVE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/13/19
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E99 - Health - General and Rehabilitative N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 TAMMY JEROME
Signature Title DIRECTOR
Signature Date 5/14/19

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