FORM 1023-EZ for BREAD OF LIFE OUTREACH MINISTRIES

Field Data
EIN 84-1926830
Case Number EO-2021190-000158
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BREAD OF LIFE OUTREACH MINISTRIES
Organization’s Mailing Address 521 JAYNES DR
City HALLS
State TN
ZIP 38040
Accounting period End 12
Primary contact name CLEOTHIS POUNDS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CLEOTHIS POUNDS
DIRECTOR
521 JAYNES DRIVE
HALLS TN 38040

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/7/2021
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code I40 - Rehabilitation Services for Offenders
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 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 CLEOTHIS POUNDS
Signature Title DIRECTOR
Signature Date 7/7/2021

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