FORM 1023-EZ for MASON CAREGIVERS CORPORATION

Field Data
EIN 47-2820650
Case Number EO-2015037-000153
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MASON CAREGIVERS CORPORATION
Organization’s Mailing Address PO BOX 28
City MASON
State TN
ZIP 38049
Accounting period End 12
Primary contact name BILLY JOE JACKSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

BILLY JOE JACKSON
PRESIDENT/EXECUTIVE DIRECTOR
PO BOX 28
MASON TN 38049

Officer/Director/Trustee Two

KEN BENARD
VICE CHAIRPERSON
PO BOX 28
MASON TN 38049

Officer/Director/Trustee Three

BELINDA SPRINGFIELD
TREASURER
PO BOX 28
MASON TN 38049

Officer/Director/Trustee Four

REGINA WILKES
SECRETARY
PO BOX 28
MASON TN 38049

Officer/Director/Trustee Five

ARNELL FREEMAN
DIRECTOR
PO BOX 28
MASON TN 38049

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/24/2014
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
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 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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