FORM 1023-EZ for CLAY BANDIT ATHLETIC ASSOCIATION

Field Data
EIN 85-3629572
Case Number EO-2021083-000679
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CLAY BANDIT ATHLETIC ASSOCIATION
Organization’s Mailing Address PO BOX 1365
City ORANGE PARK
State FL
ZIP 32065
Accounting period End 12
Primary contact name BRITTANY PARK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BLAKE E PARKER
OFFICER
318 CENTURA DRIVE
ORANGE PARK FL 32073

Officer/Director/Trustee Two

KEITH TAYLOR
VICE PRESIDENT/OFFICER
684 SOUTHLAND LANE
ORANGE PARK FL 32065

Officer/Director/Trustee Three

JOSEPH REESE
TREASURER/TRUSTEES
443 AMECA AVE
ORANGE PARK FL 32073

Officer/Director/Trustee Four

TASHELLA REESE
SECRETARY/TRUSTEES
443 AMECA AVE
ORANGE PARK FL 32073

Officer/Director/Trustee Five

JAMES RICHARDS
FOOTBALL COMMISSIONER/TRUSTEES
1246 BEDROCK DRIVE
ORANGE PARK FL 32065

Organization’s website
Organization’s email TEAMMOMBPARKER@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/1/2020
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 BLAKE E PARKER
Signature Title OFFICER
Signature Date 11/15/2020

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