FORM 1023-EZ for COUNTRY COAST CLASSIC INC

Field Data
EIN 47-4897087
Case Number EO-2015251-000403
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name COUNTRY COAST CLASSIC INC
Organization’s Mailing Address 5301 HILLCREST DRIVE
City CAMBRIA
State CA
ZIP 93428-2933
Accounting period End 12
Primary contact name ARTHUR CHAPMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ARTHUR CHAPMAN
PRESIDENT
660 ASHBY LANE
CAMBRIA CA 93428-2402

Officer/Director/Trustee Two

MATT CLEVENGER
VICE-PRESIDENT
2468 YORKSHIRE DRIVE
CAMBRIA CA 93428-3913

Officer/Director/Trustee Three

MARCELLE BAKULA
SECRETARY
2010 SKYE STREET
CAMBRIA CA 93428-3802

Officer/Director/Trustee Four

JAMES ROGERS
TREASURER
5301 HILLCREST DRIVE
CAMBRIA CA 93428-2933

Officer/Director/Trustee Five

THOMAS KENNEDY
DIRECTOR
4244 DOS CRUCES LANE
CAMBRIA CA 93428-2610

Organization’s website COUNTRYCOASTCLASSIC.ORG
Organization’s email INFO@COUNTRYCOASTCLASSIC.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/3/2015
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N12 - 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 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
Signature Title
Signature Date

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