FORM 1023-EZ for DUBLIN-LAURENS CHIEFS YOUTH ORGANIZATION INC

Field Data
EIN 83-3203691
Case Number EO-2019060-000334
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DUBLIN-LAURENS CHIEFS YOUTH ORGANIZATION INC
Organization’s Mailing Address 1101-L HILLCREST PARKWAY SUITE 29
City DUBLIN
State GA
ZIP 31021
Accounting period End 12
Primary contact name PATRICK REVEL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PATRICK REVEL
PRESIDENT
1003 CLAXTON DAIRY ROAD
DUBLIN GA 31021

Officer/Director/Trustee Two

JAMIE JOHNSON
VICE PRESIDENT
903 BUCKEYE RD
EAST DUBLIN GA 31027

Officer/Director/Trustee Three

CHRISTOPHER MARSHALL
DIRECTOR OF COMMISSION
261 CRAWFORD RD
WRIGHTSVILLE GA 31096

Officer/Director/Trustee Four

MALVIS STONE
ATHLETIC DIRECTOR
505 CYPRESS DR APT B
DUBLIN GA 31021

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/15/19
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N64 - Soccer Clubs, Leagues
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 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 PATRICK REVEL
Signature Title PRESIDENT
Signature Date 2/27/19

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