FORM 1023-EZ for DEVIL MOUNTAIN DISC GOLF CLUB

Field Data
EIN 82-2791989
Case Number EO-2017311-000269
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DEVIL MOUNTAIN DISC GOLF CLUB
Organization’s Mailing Address 12257 ALCOSTA BLVD
City SAN RAMON
State CA
ZIP 94583
Accounting period End 12
Primary contact name CHRIS DANA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHRIS DANA
PRESIDENT
12257 ALCOSTA BLVD
SAN RAMON CA 94583

Officer/Director/Trustee Two

CHRIS BOSWELL
VICE PRESIDENT
3900 BUSINESS CENTER DR APT 9306
MARTINEZ CA 94534

Officer/Director/Trustee Three

ELIZABETH AUBUCHON
SECRETARY
1355 CREEKSIDE DR APT 410
WALNUT CREEK CA 94596

Officer/Director/Trustee Four

JON CLUGSTON
COURSE MANAGER
2144 KNOLLWOOD DR
MARTINEZ CA 94553

Officer/Director/Trustee Five

CHAD INMAN
COURSE MANAGER
823 CARQUINEZ WAY
MARTINEZ CA 94553

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/20/2017
Organization Incorporation State CA
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 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
Signature Title
Signature Date

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