FORM 1023-EZ for COLLEGE GROVE LIONS CLUB CHARITIES

Field Data
EIN 47-2411375
Case Number EO-2014336-000403
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name COLLEGE GROVE LIONS CLUB CHARITIES
Organization’s Mailing Address 8607 HORTON HIGHWAY
City CHAPEL HILL
State TN
ZIP 37034
Accounting period End 12
Primary contact name PAM ASHWORTH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

PAM ASHWORTH
PRESIDENT
8607 HORTON HIGHWAY
CHAPEL HILL TN 37034

Officer/Director/Trustee Two

MISTY RILEY
SECRETARY
6992 ARNO ALLISONA RD
COLLEGE GROVE TN 37046

Officer/Director/Trustee Three

TAMMEY BALTZ
TREASURER
6610 BATEY FARM RD
COLLEGE GROVE TN 37046

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/1/2014
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N12 - Fund Raising and/or Fund Distribution
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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