FORM 1023-EZ for HOMELESS NONPROFIT NETWORK

Field Data
EIN 81-1380600
Case Number EO-2016060-000399
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HOMELESS NONPROFIT NETWORK
Organization’s Mailing Address 807 HOPEWELL STREET
City DANDRIDGE
State TN
ZIP 37725
Accounting period End 12
Primary contact name KAREN SUE BLUM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KAREN BLUM
MANAGING DIRECTOR
807 HOPEWELL ST
DANDRIDGE TN 37725

Officer/Director/Trustee Two

DEIDRE FISCHER
AGENT
935 KING RD
KODAK NC 37764

Officer/Director/Trustee Three

MATTHEW KINGSLEY
AGENT
12333 SANDRINGHAM PL
CHARLOTTE NC 28262

Officer/Director/Trustee Four

GERRY KINGSLEY
AGENT
6420 PENCADE LN
CHARLOTTE NC 28215

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/4/2016
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L80 - Housing Support Services -- Other
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 Yes
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 Yes
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 No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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