FORM 1023-EZ for CHAMPIONS CHOICE

Field Data
EIN 37-1844115
Case Number EO-2017019-000263
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CHAMPIONS CHOICE
Organization’s Mailing Address 19036 HELMER RD LOT I
City BELLE FOURCHE
State SD
ZIP 57717
Accounting period End 12
Primary contact name ANTHONY CLEBERG
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

STONEY KILMER
PRESIDENT DIRECTOR
19036 HELMER RD LOT I
BELLE FOURCHE SD 57717

Officer/Director/Trustee Two

STEVEN GREER
DIRECTOR
908 PINEDALE DR
SPEARFISH SD 57783

Officer/Director/Trustee Three

CLAY HANSEN
TREASURER
817 EAST IOWA ST
RAPID CITY SD 57701

Officer/Director/Trustee Four

ANTHONY CLEBERG
ASSISTANT TREASURER
5135 CARRIAGE HILLS DR
RAPID CITY SD 57702-9279

Officer/Director/Trustee Five

CHET KILMER
DIRECTOR
203 LARIET COURT
SPEARFISH SD 57783

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/12/1997
Organization Incorporation State SD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, N.E.C.
Organization’s purpose Charitable: No
Religious: No
Educational: No
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
Signature Title
Signature Date

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