FORM 1023-EZ for TRIPLE THREAT CLUB INC

Field Data
EIN 81-2786727
Case Number EO-2016274-000133
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TRIPLE THREAT CLUB INC
Organization’s Mailing Address 861 RETA STREET
City CLARKDALE
State AZ
ZIP 86324
Accounting period End 1
Primary contact name THAD GARLICK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TANDY TAYLOR
DIRECTOR
861 RETA STREET
CLARKDALE AZ 86324

Officer/Director/Trustee Two

ALICIA SORENSEN
DIRECTOR
349 LAUGHING HILL DRIVE
CLARKDALE AZ 86324

Officer/Director/Trustee Three

BETH FANGMAN
DIRECTOR
4875 EAST SOMERSET DRIVE
CORNVILLE AZ 86325

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/26/2016
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: No
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
Signature Title
Signature Date

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