FORM 1023-EZ for ST JAMES YOUTH FOOTBALL ASSOCIATION

Field Data
EIN 20-5183052
Case Number EO-2014351-000100
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ST JAMES YOUTH FOOTBALL ASSOCIATION
Organization’s Mailing Address 13021 STATE ROUTE V
City ROLLA
State MO
ZIP 65401
Accounting period End 4
Primary contact name DERRIC FANE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

RANDY ALTIS
PRESIDENT
18599 COUNTY ROAD 1050
ST. JAMES MO 65559

Officer/Director/Trustee Two

JASON PETTY
VICE PRESIDENT
16900 COUNTY ROAD 1100
ST. JAMES MO 65559

Officer/Director/Trustee Three

BRYAN CHITWOOD
SECRETARY
201 MATLOCK DRIVE
ST. JAMES MO 65559

Officer/Director/Trustee Four

DERRIC FANE
TREASURER
13021 STATE ROUTE V
ROLLA MO 65401

Organization’s website WWW.STJAMESYOUTHFOOTBALL.ORG
Organization’s email RANDY.ALTIS@MEEKLUMBER.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/18/2014
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N65 - Football Clubs, Leagues
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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