FORM 1023-EZ for NORTH AUGUSTA YELLOW JACKET CLUB INC

Field Data
EIN 27-1513911
Case Number EO-2015205-000281
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NORTH AUGUSTA YELLOW JACKET CLUB INC
Organization’s Mailing Address P O BOX 6524
City NORTH AUGUSTA
State SC
ZIP 29841
Accounting period End 12
Primary contact name DONALD H WHITE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

BRADLEY SIVERHUS
PRESIDENT
123 MAIN STREET
NORTH AUGUSTA SC 29841

Officer/Director/Trustee Two

DONALD WHITE
LEGAL OFFICER
511 W MARTINTOWN ROAD
NORTH AUGUSTA SC 30907

Officer/Director/Trustee Three

WILLIAM PICCIANO
VICE PRESIDENT
265 BRANCH WAY
NORTH AUGUSTA SC 29841

Officer/Director/Trustee Four

MICHELE PICCIANO
SECRETARY
265 BRANCH WAY
NORTH AUGUSTA SC 29841

Officer/Director/Trustee Five

ROBERT BIGGER
TREASURER
5 GREEN FOREST COURT
NORTH AUGUSTA SC 29841

Organization’s website NAYELLOWJACKETCLUB.COM
Organization’s email BRADSIVERHUS@COMCAST.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/28/1996
Organization Incorporation State SC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N11 - Single Organization Support
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 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
Signature Title
Signature Date

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