FORM 1023-EZ for LIGHTWORK INC

Field Data
EIN 30-0914542
Case Number EO-2016216-000231
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LIGHTWORK INC
Organization’s Mailing Address PO BOX 680704
City FRANKLIN
State TN
ZIP 37068
Accounting period End 12
Primary contact name JESS FERGUSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JESS FERGUSON
FOUNDER AND EXECUTIVE DIRECTOR
PO BOX 680704
FRANKLIN TN 37068

Officer/Director/Trustee Two

CAMILLE CARTER
PRESIDENT (BOARD MEMBER)
2733 ROSEDALL PLACE
NASHVILLE TN 37211

Officer/Director/Trustee Three

BRANDON POWELL
SECRETARY AND TREASURER
506 CROSSWOOD COURT
FRANKLIN TN 37214

Organization’s website WWW.LIGHTWORKINC.ORG
Organization’s email LIGHTWORKINC@OUTLOOK.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/20/2016
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F60 - Counseling, Support Groups
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 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
Signature Title
Signature Date

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