FORM 1023-EZ for BLEDSOE COUNTY CANCER CARE TEAM INC

Field Data
EIN 84-3476642
Case Number EO-2019301-000593
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLEDSOE COUNTY CANCER CARE TEAM INC
Organization’s Mailing Address 12555 OLD STATE HIGHWAY 28
City PIKEVILLE
State TN
ZIP 37367
Accounting period End 12
Primary contact name GARY BURTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RUTH BURTON
PRESIDENT
12555 OLD STATE HIGHWAY 28
PIKEVILLE TN 37367

Officer/Director/Trustee Two

GAIL DENNEY
TREASURER
611 BIG SPRING GAP ROAD
PIKEVILLE TN 37367

Officer/Director/Trustee Three

DEBBY COLLIER
SECRETARY
1863 WATSON LOOP ROAD
PIKEVILLE TN 37367

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/24/19
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G30 - Cancer
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 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 RUTH BURTON
Signature Title PRESIDENT
Signature Date 10/24/19

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