FORM 1023-EZ for JACKSON ROD AND CUSTOM CAR CLUB

Field Data
EIN 46-4835468
Case Number EO-2015140-000279
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name JACKSON ROD AND CUSTOM CAR CLUB
Organization’s Mailing Address 2248 ARLAN REASON ROAD
City BELLS
State TN
ZIP 38006
Accounting period End 12
Primary contact name CLARK COWART
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DANIEL JACKSON
PRESIDENT
2397 HWY 79 NORTH
BROWNSVILLE TN 38012

Officer/Director/Trustee Two

CLARK COWART
TREASURER
2248 ARLAN REASON ROAD
BELLS TN 38006

Officer/Director/Trustee Three

TOYA HOPPER
SECRETARY
28 NEW DEAL ROAD
JACKSON TN 38305

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/17/2014
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N50 - Recreational, Pleasure, or Social Club
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 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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