FORM 1023-EZ for BARTLETT KIWANIS FOUNDATION INC

Field Data
EIN 81-4986247
Case Number EO-2017027-000227
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BARTLETT KIWANIS FOUNDATION INC
Organization’s Mailing Address 6277 HAWTHORNE ROAD
City BARTLETT
State TN
ZIP 38134
Accounting period End 10
Primary contact name DAVID J HARVILL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARK GRIFFY
DIRECTOR
7454 DELMONICO COVE
MEMPHIS TN 38135

Officer/Director/Trustee Two

DAVID HARVILL
DIRECTOR
6277 HAWTHORNE ROAD
BARTLETT TN 38134-5919

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/5/2016
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T30 - Public Foundations
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
Signature Title
Signature Date

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