FORM 1023-EZ for 12TH MAN LEGACY INC

Field Data
EIN 46-4803555
Case Number EO-2019031-000101
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name 12TH MAN LEGACY INC
Organization’s Mailing Address P O BOX 504
City MAYFIELD
State KY
ZIP 42066
Accounting period End 12
Primary contact name ASHLEY GROOMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JARROD THOMPSON
PRESIDENT
246 HAYMARKET CORNER ROAD
MAYFIELD KY 42066

Officer/Director/Trustee Two

VERONICA ATHERTON
SECRETARY
1700 STATE ROUTE 1276
MAYFIELD KY 42066

Officer/Director/Trustee Three

RICKY BINKLEY
VICE PRESIDENT
203 GALAHAD COURT
MAYFIELD KY 42066

Officer/Director/Trustee Four

KEVIN WIGGINS
TREASURER
5539 STATE ROUTE 97
MAYFIELD KY 42066

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/6/14
Organization Incorporation State KY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name JARROD THOMPSON
Signature Title PRESIDENT
Signature Date 1/2/19
EIN 46-4803555
Case Number EO-2015012-000485
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name 12TH MAN LEGACY INCORPORATED
Organization’s Mailing Address 501 WEST JAMES STREET
City MAYFIELD
State KY
ZIP 42066
Accounting period End 12
Primary contact name RICHIE KEMP
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TIMOTHY JONES
DIRECTOR
501 WEST JAMES STREET
MAYFIELD KY 42066

Officer/Director/Trustee Two

JARROD THOMPSON
DIRECTOR
2239 STATE ROUTE 121 NORTH
MAYFIELD KY 42066

Officer/Director/Trustee Three

MICHAEL HAYDEN
DIRECTOR
590 STATE ROUTE 339 SOUTH
MAYFIELD KY 42066

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/6/2014
Organization Incorporation State KY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 No
One Third Support Gifts Yes
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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