FORM 1023-EZ for NEW YORK ADAPTIVE GOLF INC

Field Data
EIN 86-2303185
Case Number EO-2021093-000420
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name NEW YORK ADAPTIVE GOLF INC
Organization’s Mailing Address 229 STATE ROUTE 104A
City OSWEGO
State NY
ZIP 13126
Accounting period End 12
Primary contact name GREGORY M CALLEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GREGORY CALLEN
PRESIDENT
2991 STATE ROUTE 48
OSWEGO NY 13126

Officer/Director/Trustee Two

WILLIAM WEIMER
VICE PRESIDENT
1243 RATHBURN RD
OSWEGO NY 13126

Officer/Director/Trustee Three

PHYLISA SOVA
TREASURER
261 W 4TH ST
OSWEGO NY 13126

Officer/Director/Trustee Four

AMANDA BROWNELL
SECRETARY
104 W CAYUGA ST APT 2
OSWEGO NY 13126

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/25/2021
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N72 - Special Olympics
Organization’s purpose Charitable: Yes
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 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 WILLIAM WEIMER
Signature Title VICE PRESIDENT
Signature Date 3/1/2021

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