FORM 1023-EZ for NORTHERN ARIZONA YOUTH ATHLETICS CLUB

Field Data
EIN 82-0960025
Case Number EO-2017093-000419
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NORTHERN ARIZONA YOUTH ATHLETICS CLUB
Organization’s Mailing Address 963 N SOLIZ ST
City DEWEY
State AZ
ZIP 86327
Accounting period End 5
Primary contact name RICHARD NOLLET
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RICHARD NOLLET
PRESIDENT
963 N SOLIZ ST
DEWEY AZ 86327

Officer/Director/Trustee Two

KERI NOLLET
TREASURER
963 N SOLIZ ST
DEWEY AZ 86327

Officer/Director/Trustee Three

GABE GARDUNO
VICE PRESIDENT
1579 N LISA LN
PRESCOTT AZ 86301

Officer/Director/Trustee Four

TONY LIBBY
MEMBER AT LARGE
12933 E MADRID ST
DEWEY AZ 86327

Officer/Director/Trustee Five

JACK PERKINS
MEMBER AT LARGE
7440 N PARK CREST LN
PRESCOTT VALLEY AZ 86315

Organization’s website
Organization’s email PVYOUTHWRESTLING@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/24/2017
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O12 - Fund Raising and/or Fund Distribution
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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