FORM 1023-EZ for BACK COUNTRY HORSEMEN OF TENNESSEE

Field Data
EIN 27-1634369
Case Number EO-2016078-000294
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BACK COUNTRY HORSEMEN OF TENNESSEE
Organization’s Mailing Address 7827 HORSE TRAIL
City GEORGETOWN
State TN
ZIP 37336-5050
Accounting period End 12
Primary contact name JERRY FENSTERMAKER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

BOBBY MITCHELL
PRESIDENT
570 SUNNYSIDE ROAD
SWEETWATER TN 37874

Officer/Director/Trustee Two

TERRI HAVER
SECRETARY
2080 BANCROFT ROAD
MCDONALD TN 37353

Officer/Director/Trustee Three

JERRY FENSTERMAKER CPA
TREASURER
7827 HORSE TRAIL
GEORGETROWN TN 37336-5050

Officer/Director/Trustee Four

BRUCE RUSSELL
BOARD MEMBER
959 COLE PLACE ROAD
ALLARDT TN 38504

Officer/Director/Trustee Five

LARRY JEFFERS
BOARD MEMBER
153 VAUGHN ROAD
HAMPTON TN 37658

Organization’s website
Organization’s email CPARIDER@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/19/2010
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N69 - Equestrian, Riding
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 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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