FORM 1023-EZ for 875 SQUAD CLUB

Field Data
EIN 82-1281790
Case Number EO-2017116-000264
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name 875 SQUAD CLUB
Organization’s Mailing Address 100779 BEAR RD
City NIPTON
State CA
ZIP 92364
Accounting period End 12
Primary contact name GORGE ETMON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GORGE ETMON
PRESIDENT
100779 BEAR RD
NIPTON CA 92364

Officer/Director/Trustee Two

TAMI MAUCH
VICE PRESIDENT
100779 BEAR RD
NIPTON CA 92364

Officer/Director/Trustee Three

CARLOS SANTANDER
TREASURER
100779 BEAR RD
NIPTON CA 92364

Officer/Director/Trustee Four

GREGORY SEIFERT
SECRETARY
100779 BEAR RD
NIPTON CA 92364

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/2017
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Z99 - Unclassified
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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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