FORM 1023-EZ for DMV ANESTASIA GOLF CLUB

Field Data
EIN 47-3267943
Case Number EO-2018249-000136
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DMV ANESTASIA GOLF CLUB
Organization’s Mailing Address 12799 KERRYDALE RD
City WOODBRIDGE
State VA
ZIP 22193
Accounting period End 12
Primary contact name JOHN BEARD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

FREDERICK JOHNSON
DIRECTOR
11985 MOLLY PITCHER CIRCLE
MANASSAS VA 20109

Officer/Director/Trustee Two

FRANZ RAMSAY
OFFICER
16168 RADBURN ST
WOODBRIDGE VA 22191

Officer/Director/Trustee Three

JOHN BEARD
OFFICER
12799 KERRYDALE ROAD
WOODBRIDGE VA 22193

Officer/Director/Trustee Four

RAMON LATORRE
OFFICER
6343 VILLAGE CENTER DR APT 123
BEALETON VA 22712

Organization’s website DMVANESTASIAGOLFCLUB.COM
Organization’s email JBEARD@BEARDANDASSOCIATESLLC.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/1/15
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T22 - Private Independent Foundations
Organization’s purpose Charitable: Yes
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 JOHN BEARD
Signature Title OFFICER
Signature Date 9/4/18

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