FORM 1023-EZ for PREVENTION COALITION OF BEDORD COUNTY

Field Data
EIN 83-3902404
Case Number EO-2019108-000233
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PREVENTION COALITION OF BEDORD COUNTY
Organization’s Mailing Address 112 LEE ANN DR
City SHELBYVILLE
State TN
ZIP 37160
Accounting period End 6
Primary contact name BOB HUDSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARVIN KOONCE
DR
1037 UNION STREET
SHELBYVILLE TN 37160

Officer/Director/Trustee Two

HOWARD RUPARD
DR
221 LANE PARKWAY
SHELBYVILLE TN 37160

Officer/Director/Trustee Three

DENISE LINDSEY
DR
1701 HWY 130 W
SHELBYVILLE TN 37160

Officer/Director/Trustee Four

SUE FLETCHER
TREASURER
BROWN LANE
SHELBYVILLE TN 37160

Officer/Director/Trustee Five

ROBERT PHILLIPS
DR
217 DEER POINT RD
UNIONVILLE TN 37180

Organization’s website WWW.PCOFBC.ORG
Organization’s email PCOFBCTN@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/11/19
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F21 - Alcohol, Drug Abuse, Prevention Only
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 DENISE LINDSEY
Signature Title DR
Signature Date 4/16/19

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