FORM 1023-EZ for LOIS M DEBERRY INSTITUTE FOR PUBLICPOLICY

Field Data
EIN 47-3868856
Case Number EO-2015189-000034
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LOIS M DEBERRY INSTITUTE FOR PUBLICPOLICY
Organization’s Mailing Address 3130 SPRING HILL DR
City MEMPHIS
State TN
ZIP 38127
Accounting period End 4
Primary contact name JESSE JOHNSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JESSE JOHNSON
PRESIDENT/CEO/BOARD CHAIR
3130 SPRING HILL DRIVE
MEMPHIS TN 38127-7457

Officer/Director/Trustee Two

REGINALD TATE
TREASURER/DIRECTOR
3422 TOURNAMENT DRIVE
MEMPHIS TN 38125

Officer/Director/Trustee Three

NELLIE POWELL
SECRETARY/DIRECTOR
4222 WESTGATE TRAIL
MEMPHIS TN 38141

Officer/Director/Trustee Four

MARY FREEMAN
DIRECTOR
380 WINDING RIVER CIRCLE 104
MEMPHIS TN 38120

Officer/Director/Trustee Five

LETICA TOWNS
DIRECTOR
2429 VERDUN
MEMPHIS TN 38114

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/29/2015
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O54 - Youth Development - Citizenship Programs
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 No
Donation of funds Yes
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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