FORM 1023-EZ for TEEN BASS ASSOCIATION

Field Data
EIN 86-2289362
Case Number EO-2021109-000363
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TEEN BASS ASSOCIATION
Organization’s Mailing Address 4414 LEESVILLE ROAD
City LYNCH STATION
State VA
ZIP 24571
Accounting period End 12
Primary contact name FAITH WILT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SEAN WILT
DIRECTOR
4414 LEESVILLE ROAD
LYNCH STATION VA 24571

Officer/Director/Trustee Two

LORI WATKINS
DIRECTOR
404 WESTWOOD DRIVE
ALTAVISTA VA 24517

Officer/Director/Trustee Three

GARY PENN
DIRECTOR
1717 AVONDALE DRIVE
ALTAVISTA VA 24517

Officer/Director/Trustee Four

FAITH WILT
DIRECTOR
4414 LEESVILLE ROAD
LYNCH STATION VA 24571

Organization’s website
Organization’s email TEENBASSOFFICE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/15/2021
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N61 - Fishing, Hunting Clubs
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 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 FAITH WILT
Signature Title DIRECTOR
Signature Date 4/15/2021

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