FORM 1023-EZ for AMBER COMMUNITY CLUB

Field Data
EIN 45-3078715
Case Number EO-2019183-000052
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name AMBER COMMUNITY CLUB
Organization’s Mailing Address 15362 E23 COUNTY HOME RD
City ANAMOSA
State IA
ZIP 52205
Accounting period End 12
Primary contact name BOBBY KRUM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BOBBY KRUM
PRESIDENT
15362 E23 COUNTY HOME RD
ANAMOSA IA 52205

Officer/Director/Trustee Two

JOE WAGNER
VICE-PRESIDENT
15173 E23 COUNTY HOME RD
ANAMOSA IA 52205

Officer/Director/Trustee Three

HEIDI KRUM
SECRETARY
15362 E23 COUNTY HOME RD
ANAMOSA IA 52205

Officer/Director/Trustee Four

SELINA GRANT
TREASURER
11775 136TH AVE
CENTER JUNCTION IA 52212

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/12/18
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A82 -
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
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 JOE WAGNER
Signature Title VICE-PRESIDENT
Signature Date 6/30/19

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