FORM 1023-EZ for CIRCLE 6 CLUB

Field Data
EIN 81-3103667
Case Number EO-2016223-000092
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CIRCLE 6 CLUB
Organization’s Mailing Address PO BOX 651252
City STERLING
State VA
ZIP 20165
Accounting period End 12
Primary contact name CHARLES HENDERSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHARLES HENDERSON
PRESIDENT
8 LINDENWOOD CT
STERLING VA 20165

Officer/Director/Trustee Two

MAJOR DEDRICK
VICE PRESIDENT
22941 WHITEHALL TERRACE
STERLING VA 20166

Officer/Director/Trustee Three

BEVERLY BRAY
SECRETARY
148 CLUBHOUSE APT 204
LEESBURG VA 20175

Officer/Director/Trustee Four

BETTY HENDERSON
TREASURER
8 LINDENWOOD CT
STERLING VA 20165

Organization’s website
Organization’s email CIRCLE6CLUB@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/1/2016
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Y12 - Fund Raising and/or Fund Distribution
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 Yes
One Third Support Gifts No
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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