FORM 1023-EZ for APPALACHIAN PROMISE OF CLAIBORNE COUNTY

Field Data
EIN 35-2629519
Case Number EO-2018204-000201
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name APPALACHIAN PROMISE OF CLAIBORNE COUNTY
Organization’s Mailing Address PO BOX 443
City TAZEWELL
State TN
ZIP 37879
Accounting period End 4
Primary contact name SHERRI HOSKINS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHERRI HOSKINS
PRESIDENT
173 WOODSIDE
HARROGATE TN 37752

Officer/Director/Trustee Two

TAMMY KOKE
VICE PRESIDENT
197 WOODSIDE
HARROGATE TN 37752

Officer/Director/Trustee Three

ALESHA PAYNE
CHAIRMAN
173 KARS LANE
TAZEWELL TN 37879

Officer/Director/Trustee Four

DR RON DUBIN
DIRECTOR
337 YORKSHIRE
HARROGATE TN 37752

Officer/Director/Trustee Five

ANGELA BURCH
SECRETARY
151 YORKSHIRE
HARROGATE TN 37752

Organization’s website WWW.APCCCLAIBORNE.COM
Organization’s email APCCCLAIBORNE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/11/18
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Z99 - Unclassified
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 SHERRI HOSKINS
Signature Title PRESIDENT
Signature Date 7/19/18

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