FORM 1023-EZ for CAMDEN CYCLING CLUB INC

Field Data
EIN 46-1146290
Case Number EO-2016266-000142
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CAMDEN CYCLING CLUB INC
Organization’s Mailing Address PO BOX 5054
City ST. MARYS
State GA
ZIP 31558
Accounting period End 12
Primary contact name JAMES A POTTER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAMES POTTER
CHIEF EXECUTIVE OFFICER
284 CMG PLACE
WOODBINE GA 31569

Officer/Director/Trustee Two

THERESA CLEARY
CHIEF FINANCIAL OFFICER
162 WHIPPOORWILL CIRCLE
KINGSLAND GA 31548

Officer/Director/Trustee Three

ASHLEY COOPER-HEATH
SECRETARY
321 LANDING DR
KINGSLAND GA 31548

Organization’s website CAMDENCYCLINGCLUB.ORG
Organization’s email CAMDENCYCLINGCLUBGA@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/6/2016
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code M42 - Automotive Safety
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 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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