FORM 1023-EZ for KNOXVILLE REP PAYEE SERVICES

Field Data
EIN 47-2744539
Case Number EO-2015049-000026
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KNOXVILLE REP PAYEE SERVICES
Organization’s Mailing Address PO BOX 70552
City KNOXVILLE
State TN
ZIP 37938-4086
Accounting period End 12
Primary contact name JENNIFER ROWE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JENNIFER ROWE
PRESIDENT
7621 STAR GAZING LANE
KNOXVILLE TN 37938-4086

Officer/Director/Trustee Two

ROY AMRANI
OFFICER
7621 STAR GAZING LANE
KNOXVILLE TN 37938-4086

Organization’s website
Organization’s email KNOXPAYEESERVICES@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/1/2015
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P80 - Services to Promote the Independence of Specific Populations
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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