FORM 1023-EZ for GOLDEN VALLEY SWIM CLUB HENRY COUNTY

Field Data
EIN 85-3554518
Case Number EO-2021082-000235
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GOLDEN VALLEY SWIM CLUB HENRY COUNTY
Organization’s Mailing Address 106 NW 3542P LN
City CLINTON
State MO
ZIP 64735
Accounting period End 12
Primary contact name SHELLY JOHNSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHELLY JOHNSON
PRESIDENT
106 NW 3542P LN
CLINTON MO 64735

Officer/Director/Trustee Two

NINA WETZEL
VICE PRESIDENT
905 SHADOW HILL CIRCLE
CLINTON MO 64735

Officer/Director/Trustee Three

LESLIE MILLS
SECRETARY
245 NE 104 RD
CLINTON MO 64735

Officer/Director/Trustee Four

JENNIFER GILBERT
TREASURER
122 NE 201ST ST
CLINTON MO 64735

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/27/2020
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N67 - Swimming, Water Recreation
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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 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 SHELLY JOHNSON
Signature Title PRESIDENT
Signature Date 1/29/2021

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