FORM 1023-EZ for DOUGLAS COUNTY DIABLOS INC

Field Data
EIN 47-4977668
Case Number EO-2016039-000083
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DOUGLAS COUNTY DIABLOS INC
Organization’s Mailing Address 4404 HARVARD
City LAWRENCE
State KS
ZIP 66049
Accounting period End 12
Primary contact name KEN BRUNGARDT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KEN BRUNGARDT
PRESIDENT
4404 HARVARD
LAWRENCE KS 66049

Officer/Director/Trustee Two

DAWN HONARVAR
TREASURER
PO BOX 4666
LAWRENCE KS 66046

Officer/Director/Trustee Three

MEHDI HONARVAR
SECRETARY
PO BOX 4666
LAWRENCE KS 66046

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/3/2015
Organization Incorporation State KS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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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