FORM 1023-EZ for HUMPHREYS COUNTY LONG TERM RECOVERYORGANIZATION
| Field | Data |
|---|---|
| EIN | 45-2537454 |
| Case Number | EO-2019079-000318 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | HUMPHREYS COUNTY LONG TERM RECOVERYORGANIZATION |
| Organization’s Mailing Address | 1298 CAPPS RD |
| City | MCEWEN |
| State | TN |
| ZIP | 37101 |
| Accounting period End | 6 |
| Primary contact name | KARIN LANDERS |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
KARIN LANDERS
DIRECTOR/CHAIR
1298 CAPPS RD
MCEWEN TN 37101
Officer/Director/Trustee Two
REBECCA ANN PEEK
SECRETARY
2467 LITTLE BLUE CREEK RD
MCEWEN TN 37101
Officer/Director/Trustee Three
ANDY DANIELS
PRESIDENT
314 HURRICANE MILLS
WAVERLY TN 37185
Officer/Director/Trustee Four
LISA CARNAHAN
TREASURER
107 A DOGWOOD CR
WAVERLY TN 37185
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 5/18/11 |
| Organization Incorporation State | TN |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | M20 - Disaster Preparedness and Relief Services |
| 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 | Yes |
| 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 | Yes |
| Correctness Declaration | Yes |
| Signature Name | KARIN LANDERS |
| Signature Title | DIRECTOR/CHAIR |
| Signature Date | 3/15/19 |
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