FORM 1023-EZ for GOOD SHEPHERDS FOUNDATION

Field Data
EIN 83-3964109
Case Number EO-2019077-000451
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GOOD SHEPHERDS FOUNDATION
Organization’s Mailing Address 827 BETTY BOYD LN
City ATOKA
State TN
ZIP 38004
Accounting period End 12
Primary contact name JAMES MILLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAMES MILLER JR
DIRECTOR
827 BETTY BOYD LN
ATOKA TN 38004-5206

Officer/Director/Trustee Two

SHANTAY COOK
TREASURER
827 BETTY BOYD LN
ATOKA TN 38004-5206

Organization’s website
Organization’s email THEGOODSHEPHERDSFOUNDATION@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/1/19
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N31 - Community Recreational Centers
Organization’s purpose Charitable: Yes
Religious: No
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 Yes
Donation of funds Yes
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 Yes
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 JAMES MILLER JR
Signature Title DIRECTOR
Signature Date 3/14/19

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