FORM 1023-EZ for CAROLINA YOUTH DANCE ACADEMY

Field Data
EIN 81-3145179
Case Number EO-2016347-000333
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CAROLINA YOUTH DANCE ACADEMY
Organization’s Mailing Address 341 RIGGANS WAY
City FRANKLINTON
State NC
ZIP 27525
Accounting period End 12
Primary contact name BRIAN SHAW
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DEBBIE RAMSEY
PRESIDENT, DIRECTOR
341 RIGGANS WAY
FRANKLINTON NC 27525

Officer/Director/Trustee Two

WESLEY BOZ
TREASURER, DIRECTOR
341 RIGGANS WAY
FRANKLINTON NC 27525

Officer/Director/Trustee Three

RYAN BOZ
VICE-PRESIDENT, DIRECTOR
341 RIGGANS WAY
FRANKLINTON NC 27525

Officer/Director/Trustee Four

ANN JAGGER
SECRETARY, DIRECTOR
210 JAMES JACKSON AVENUE
CARY NC 27513

Officer/Director/Trustee Five

BRIAN SHAW
DIRECTOR
3126 BELVIN DRIVE
RALEIGH NC 27609

Organization’s website
Organization’s email BSHAW@SCHWARTZ-SHAW.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/29/2016
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A62 - Dance
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 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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