FORM 1023-EZ for FORT SMITH EPILEPSY SUPPORT GROUP

Field Data
EIN 82-2001190
Case Number EO-2018193-000317
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FORT SMITH EPILEPSY SUPPORT GROUP
Organization’s Mailing Address 2701 GLEN FLORA WAY
City FORT SMITH
State AR
ZIP 72908
Accounting period End 12
Primary contact name HOWERTON LILLIAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TERESA BROWN
DIRECTOR
2701 GLEN FLORA WAY
FORT SMITH AR 72908

Officer/Director/Trustee Two

ROBERT BROWN
CO- DIRECTOR
2701 GLEN FLORA WAY
FORT SMITH AR 72908

Officer/Director/Trustee Three

LILLIAN HOWERTON
ORGANIZER
2 CREEK RD
MORRILTON AR 72110

Officer/Director/Trustee Four

KARLA HARKINS
TREASURER
607 PINE CLIFF DRIVE
VAN BUREN AR 72956

Officer/Director/Trustee Five

EDDIE PHILLIPS
DEVELOPMENT DIRECTOR
BOX 993
ALMA AR 72921

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/25/18
Organization Incorporation State AR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G54 - Epilepsy
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 LILLIAN HOWERTON
Signature Title ORGANIZER
Signature Date 7/9/18

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