FORM 1023-EZ for COUNTRYSIDE BASEBALL INC

Field Data
EIN 87-2143782
Case Number EO-2021228-000606
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name COUNTRYSIDE BASEBALL INC
Organization’s Mailing Address 2891 MEADOW OAK DR E
City CLEARWATER
State FL
ZIP 33761
Accounting period End 12
Primary contact name CARY NEVINS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CARY NEVINS
PRESIDENT
2891 MEADOW OAK DR E
CLEARWATER FL 33761

Officer/Director/Trustee Two

JR GRANTHAM
VICE PRESIDENT
3617 S LAKE SHORE LANE
CLEARWATER FL 33761

Officer/Director/Trustee Three

JENNIFER ALLEN
TREASURER
3096 BLUE HERON STREET
SAFETY HARBOR FL 34695

Officer/Director/Trustee Four

HOLLY LARSON
SECRETARY
1406 PINEAPPLELANE
CLEARWTER FL 33759

Organization’s website
Organization’s email CARYNEVINS5@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/12/2021
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N63 - Baseball, Softball
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 CARY NEVINS
Signature Title PRESIDENT
Signature Date 8/13/2021

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