FORM 1023-EZ for MEMPHIS INLINE RACING INCORPORATED

Field Data
EIN 47-5336178
Case Number EO-2015345-000284
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MEMPHIS INLINE RACING INCORPORATED
Organization’s Mailing Address 1311 HUNTERS MILL TRAIL
City COLLIERVILLE
State TN
ZIP 38017
Accounting period End 12
Primary contact name JAMES COOK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JAMES COOK
PRESIDENT/CEO
1700 NAPIER WOODS DRIVE
COLLIERVILLE TN 38017

Officer/Director/Trustee Two

LISA CARLSON
CHIEF OPERATING OFFICER
1311 HUNTERS MILL TRAIL
COLLIERVILLE TN 38017

Officer/Director/Trustee Three

ALEJANDRINA BIBIANO
CHIEF FINANCIAL OFFICER
1416 WOLF RIDGE DRIVE
COLLIERVILLE TN 38017

Officer/Director/Trustee Four

REBECCA GOMEZ
SECRETARY
313 BOBWHITE DRIVE
BYHALIA MS 38611

Officer/Director/Trustee Five

SCOTT PITTENGER
BOARD MEMBER
243 WOLF RIDGE COVE
COLLIERVILLE TN 38017

Organization’s website
Organization’s email TEAMPRODIGYMEMPHIS@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/15/2015
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N70 - Amateur Sports Competitions
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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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