FORM 1023-EZ for WEST TENNESSEE EMMAUS COMMUNITY INC

Field Data
EIN 58-1737055
Case Number EO-2014302-000090
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name WEST TENNESSEE EMMAUS COMMUNITY INC
Organization’s Mailing Address PO BOX 10741
City JACKSON
State TN
ZIP 38308
Accounting period End 6
Primary contact name TIM HERNDON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

GARY SLOAN
COMMUNITY LAY DIRECTOR
412 E COLLEGE ST
BROWNSVILLE TN 38012

Officer/Director/Trustee Two

EDDIE CROCKER
ASST COMMUNITY LAY DIRECTOR
2493 FAIRWAY DR
DYERSBURG TN 38024

Officer/Director/Trustee Three

TINA MARTIN
SECRETARY
123 FAIRWAY DRIVE
BROWNSVILLE TN 38012

Officer/Director/Trustee Four

TIM HERNDON
TREASURER
225 LACKEY LANE
RIPLEY TN 38063

Officer/Director/Trustee Five

WALTER SMITH
DIRECTOR
24 BRACKENHOUSE SQ
JACKSON TN 38305

Organization’s website WWW.EMMAUS.TN.ORG
Organization’s email TIMHERNDON@ME.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/24/1987
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: No
Religious: Yes
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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