FORM 1023-EZ for THE EXECUTIVE GAME INC

Field Data
EIN 66-0932534
Case Number EO-2019294-000263
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE EXECUTIVE GAME INC
Organization’s Mailing Address 9053 ESTATE THOMAS STE 101
City ST THOMAS
State VI
ZIP 802
Accounting period End 12
Primary contact name ERIKA KELLERHALS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANTHONY SCHULTZ
PRESIDENT
6513 BARBADOS CIRCLE UNIT 47U
ST. THOMAS VI 802

Officer/Director/Trustee Two

JOSH JANJUA
VICE PRESIDENT
6345 SMITH BAY APT B1
ST. THOMAS VI 802

Officer/Director/Trustee Three

PATRICK CLARK
TREASURER
906 N EDGEFIELD AVENUE
DALLAS TX 75208

Officer/Director/Trustee Four

DEREK BROWN
SECRETARY
3990 SPRING VALLEY ROAD APT 635
FARMERS BRANCH TX 75244

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/1/19
Organization Incorporation State VI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W12 - 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 Yes
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 ANTHONY SCHULTZ
Signature Title PRESIDENT
Signature Date 10/17/19

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