FORM 1023-EZ for COUNTY LINE REFERRAL GROUP

Field Data
EIN 47-1256744
Case Number EO-2017298-000294
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name COUNTY LINE REFERRAL GROUP
Organization’s Mailing Address PO BOX 2112
City VAN ALSTYNE
State TX
ZIP 75495-2112
Accounting period End 12
Primary contact name TIMMERLE KELLY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARLA BUTLER
PRESIDENT
598 TOLSON AVENUE
VAN ALSTYNE TX 75495-5161

Officer/Director/Trustee Two

TIMMERLE KELLY
TREASURER
1511 ASBURY DR
VAN ALSTYNE TX 75495-2698

Officer/Director/Trustee Three

KIMBERLY USELTON
VICE PRESIDENT
382 EAGLE POINT RD
VAN ALSTYNE TX 75495-7036

Officer/Director/Trustee Four

SHERYL POWERS
VICE PRESIDENT
5029 MILAM ST
DALLAS TX 75206-6511

Officer/Director/Trustee Five

DAVID MORGAN
DIRECTOR
255 E JEFFERSON ST
VAN ALSTYNE TX 75495

Organization’s website HTTP://WWW.COUNTYLINEREFERRALGROUP.COM/
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/7/2014
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S41 - Promotion of Business
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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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