| Field | Data |
|---|---|
| EIN | 81-3843263 |
| Case Number | EO-2018229-000517 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | MAD SAM |
| Organization’s Mailing Address | 400 BENNETT CEMETERY ROAD |
| City | DECHERD |
| State | TN |
| ZIP | 37324 |
| Accounting period End | 5 |
| Primary contact name | TAMMY NANCE |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
PATRICK MATTHEWS
PRESIDENT
208 POPLAR AVENUE
HUNTLAND TN 37345
TAMMY NANCE
DIRECTOR
400 BENNETT CEMETERY ROAD
DECHERD TN 37324
BONNIE CLARK
OFFICER
109 SOUTH COLLEGE
WINCHESTER TN 37398
SUE FULMER
SECETARY
PO BOX 576
COWAN TN 37318
MARION POPE
OFFICERS
306 GLENVIEW DRIVE
ESTILL SORINGS TN 37330
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 5/14/18 |
| Organization Incorporation State | TN |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | F12 - Fund Raising and/or Fund Distribution |
| Organization’s purpose | Charitable: Yes Religious: Yes 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 | No |
| Benefit of College | No |
| Private Foundation 508(e) | Yes |
| Seeking Retroactive Reinstatement | No |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | TAMMY NANCE |
| Signature Title | DIRECTOR |
| Signature Date | 8/15/18 |
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