FORM 1023-EZ for ROCK SPRINGS AVENGERS SOCCER CLUB

Field Data
EIN 83-0300167
Case Number EO-2019298-000202
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ROCK SPRINGS AVENGERS SOCCER CLUB
Organization’s Mailing Address 30 MOSES DRIVE
City ROCK SPRINGS
State WY
ZIP 82901
Accounting period End 12
Primary contact name HILARY BREWSTER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DUSTIN MOSES
PRESIDENT/DIRECTOR
30 MOSES DRIVE
ROCK SPRINGS WY 82901

Officer/Director/Trustee Two

MELISSA MONTOYA
TREASURER/DIRECTOR
30 MOSES DRIVE
ROCK SPRINGS WY 82901

Officer/Director/Trustee Three

JOSHUA WEBB
VICE PRESIDENT/DIRECTOR
30 MOSES DRIVE
ROCK SPRINGS WY 82901

Organization’s website WWW.RSAVENGERS.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/1/13
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: Yes
Religious: No
Educational: Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name DUSTIN MOSES
Signature Title PRESIDENT/DIRECTOR
Signature Date 10/23/19

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