FORM 1023-EZ for BORN FREE FOUNDATION

Field Data
EIN 47-3722377
Case Number EO-2015107-000267
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BORN FREE FOUNDATION
Organization’s Mailing Address 100 COVEY DRIVE SUITE 204
City FRANKLIN
State TN
ZIP 37067
Accounting period End 12
Primary contact name NAOMI PASCHALL MD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

NAOMI PASCHALL MD
PRESIDENT
100 COVEY DRIVE STE 204
FRANKLIN TN 37067

Officer/Director/Trustee Two

SHEILAH GRIGGS
SECRETARY
4322 HARDING PIKE STE 417
NASHVILLE TN 37205

Officer/Director/Trustee Three

SASHA QUALKENBUSH
TREASURER
17 SAWGRASS LN
BRENTWOOD TN 37027

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/11/2015
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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