FORM 1023-EZ for APPLETON CITY OPTIMIST CLUB

Field Data
EIN 82-2763957
Case Number EO-2017265-000315
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name APPLETON CITY OPTIMIST CLUB
Organization’s Mailing Address PO BOX 165
City APPLETON CITY
State MO
ZIP 64724
Accounting period End 9
Primary contact name KELLY TINDAL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KELLY TINDALL
SECRETARY
13190 NW HIGHWAY 52
APPLETON CITY MO 64724

Officer/Director/Trustee Two

CATHERINE BROWNSBERGER
VICE PRESIDENT
14500 NW HIGHWAY P
APPLETON CITY MO 64724

Officer/Director/Trustee Three

TAMARA AVERSMAN
TREASURER
14630 NW HIGHWAY 52
APPLETON CITY MO 64724

Officer/Director/Trustee Four

ADAM STROPE
PRESIDENT
10300 NW 1001 ROAD
APPLETON CITY MO 64724

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/12/2017
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O20 - Youth Centers, Clubs, Multipurpose
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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