FORM 1023-EZ for HIGH ALTITUDE SWIM CLUB

Field Data
EIN 85-1174899
Case Number EO-2021100-000018
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HIGH ALTITUDE SWIM CLUB
Organization’s Mailing Address 275 SADDLE RIDGE ROAD
City EVANSTON
State WY
ZIP 82930
Accounting period End 12
Primary contact name KIMBERLY LARSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KIMBERLY LARSON
PRESIDENT
131 SKYLINE DR
EVANSTON WY 82930

Officer/Director/Trustee Two

STEPHEN POWERS
HEAD COACH
111 LYMAN
LYMAN WY 82937

Officer/Director/Trustee Three

SHERRI BUSCH
HEAD COACH
107 EVANS
EVANSTON WY 82930

Officer/Director/Trustee Four

ALICIA JOHNSON
TREASURER
409 MAIN ST
EVANSTON WY 82930

Officer/Director/Trustee Five

TIMALEY KERTZ
SECRETARY
PO BOX 986
LYMAN WY 82937

Organization’s website HIGHALTITUDESWIMCLUB.COM
Organization’s email HIGHALTITUDESWIMCLUB@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/26/2020
Organization Incorporation State WY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, N.E.C.
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 Yes
Donation of funds Yes
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 KIMBERLY LARSON
Signature Title PRESIDENT
Signature Date 3/23/2021

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