FORM 1023-EZ for ARRL CLAY COUNTY AMATEUR RADIO EMERGENCY SERVICE

Field Data
EIN 46-2844384
Case Number EO-2017328-000397
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ARRL CLAY COUNTY AMATEUR RADIO EMERGENCY SERVICE
Organization’s Mailing Address 225 COLLEGE AVE STE 65456
City ORANGE PARK
State FL
ZIP 32065
Accounting period End 12
Primary contact name JOSEPH BASSETT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ADRIAN GREY
EMERGENCY COORDINATOR
223 EVERGREEN LANE
MIDDLEBURG FL 32068

Officer/Director/Trustee Two

MARK FIELDS
ASSISTANT EMERGENCY COORDINATOR
1741 GUMTREE DRIVE
ORANGE PARK FL 32073

Officer/Director/Trustee Three

SCOTT ROBERTS
ASSISTANT FOR INFORMATION
2361 OAK HAMMOCK
ORANGE PARK FL 32065

Officer/Director/Trustee Four

RAY COOK
ASSISTANT FOR DIGITAL COMMUNICATION
229 DEERWOOD CIRCLE
MIDDLEBURG FL 32068

Officer/Director/Trustee Five

JOSEPH BASSETT
ASSISTANT FOR TRAINING
1503 GREENWAY PLACE
FLEMING ISLAND FL 32003

Organization’s website WWW.CLAYARES.ORG
Organization’s email CLAYCOUNTYARES@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/1/2013
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A25 - Arts Education
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: Yes
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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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