FORM 1023-EZ for SERENITY HOUSE OF TULLAHOMA INC

Field Data
EIN 20-4634679
Case Number EO-2018305-000410
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SERENITY HOUSE OF TULLAHOMA INC
Organization’s Mailing Address 313 N COLLINS ST
City TULLAHOMA
State TN
ZIP 37388
Accounting period End 12
Primary contact name JAMES DEVLIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAMES DEVLIN
CHAIR
240 DEER RUN RD
WARTRACE TN 37183-8026

Officer/Director/Trustee Two

RICK WHITFIELD
BOARD MEMBER
313 N COLLINS ST
TULLAHOMA TN 37388

Officer/Director/Trustee Three

KATHLEEN SHEA
SECRETARY TREASURER
1508 OLD ESTILL SPRINGS RD
TULLAHOMA TN 37388

Officer/Director/Trustee Four

ROBERT STARNES
BOARD MEMBER
313 N COLLINS ST
TULLAHOMA TN 37388

Officer/Director/Trustee Five

SUSIE WHITFIELD
BOARD MEMBER
313 N COLLINS ST
TULLAHOMA TN 37388

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/30/18
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F11 - Single Organization Support
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 JAMES DEVLIN
Signature Title CHAIR
Signature Date 10/30/18

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