FORM 1023-EZ for GOOD SHEPHERD RESIDENTIAL SERVICES

Field Data
EIN 26-2877520
Case Number EO-2015202-000202
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name GOOD SHEPHERD RESIDENTIAL SERVICES
Organization’s Mailing Address 3604 FAIRMEADE DRIVE
City NASHVILLE
State TN
ZIP 37218
Accounting period End 12
Primary contact name AMIRA BEAIRD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

AMIRA BEAIRD
EXECUTIVE DIRECTOR
3604 FAIRMEADE DRIVE
NASHVILLE TN 37218

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/2009
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F33 - Group Home, Residential Treatment Facility - Mental Health Related
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 Yes
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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