FORM 1023-EZ for HOLIDAY ASSISTANCE PROGRAM

Field Data
EIN 38-4015007
Case Number EO-2016347-000145
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HOLIDAY ASSISTANCE PROGRAM
Organization’s Mailing Address 105 PAVO AVENUE
City WAVERLY
State TN
ZIP 37185
Accounting period End 12
Primary contact name BRENDA ELLIOTT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRENDA ELLIOTT
CHAIRPERSON
3517 OLD BLACKTOP ROAD
MCEWEN TN 37101

Officer/Director/Trustee Two

EVONNE BROWN
CO-CHAIRPERSON
120 WESTWOOD DRIVE
WAVERLY TN 37185

Officer/Director/Trustee Three

SHIRLEY WALKER
COMMITTEE MEMBER
722 HIGHWAY 230
WAVERLY TN 37185

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/1/2016
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P58 - Gift Distribution
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 Yes
One Third Support Gifts No
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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