FORM 1023-EZ for ARIZONA BOYS STATE FOUNDATION INC

Field Data
EIN 82-0999143
Case Number EO-2017124-000102
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ARIZONA BOYS STATE FOUNDATION INC
Organization’s Mailing Address 4701 19TH AVE STE 200
City PHOENIX
State AZ
ZIP 85015
Accounting period End 12
Primary contact name JEREMY P DAVALOS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANGEL JUAREZ
SECRETARY/STAT AGENT
4701 N 19TH AVE STE 200
PHOENIX AZ 85015

Officer/Director/Trustee Two

ROBERT PAVEZA
DIRECTOR
53 DIAMOND
IRVINE AZ 92620

Officer/Director/Trustee Three

JEREMY DAVALOS
NON PROFIT DIRECTOR
7875 N MUSIC MOUNTAIN LN
PRESCOTT VALLEY AZ 86315

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/17/2017
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O54 - Youth Development - Citizenship Programs
Organization’s purpose Charitable: No
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 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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