FORM 1023-EZ for JASON EDENS MEMORIAL ASSOCIATION

Field Data
EIN 81-3212191
Case Number EO-2016197-000266
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name JASON EDENS MEMORIAL ASSOCIATION
Organization’s Mailing Address 1016 MORAN RD
City FRANKLIN
State TN
ZIP 37069
Accounting period End 12
Primary contact name JAN EDENS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

STEVEN FALK
PRESIDENT
114 ST MARYS CT
SMYRNA TN 37167

Officer/Director/Trustee Two

DOUG RENEGAR
VICE-PRESIDENT
134 GALLAGHER DR
FRANKLIN TN 37064

Officer/Director/Trustee Three

JAN EDENS
TREASURER
1016 MORAN RD
FRANKLIN TN 37069

Officer/Director/Trustee Four

KATHY ROSS
SECRETARY
6952 HARPETH GLEN TRACE
NASHVILLE TN 37221

Organization’s website
Organization’s email MONEYSHOT2@COMCAST.NET
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/16/2016
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T12 - Fund Raising and/or Fund 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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