FORM 1023-EZ for DIAMOND HILL NORTH SIDE YOUTH ASSOCIATION

Field Data
EIN 27-2555728
Case Number EO-2017317-000555
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DIAMOND HILL NORTH SIDE YOUTH ASSOCIATION
Organization’s Mailing Address PO BOX 162253
City FORT WORTH
State TX
ZIP 76161
Accounting period End 12
Primary contact name ROXANNE MARTINEZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROXANNE MARTINEZ
PRESIDENT
1315 NE 37TH ST
FORT WORTH TX 76106-3860

Officer/Director/Trustee Two

GERALD SHELBON
VICE-PRESIDENT
6612 WATERHILL LN
FORT WORTH TX 76179

Officer/Director/Trustee Three

ALFREDO GONZALEZ
TREASURER
6461 DOWNEAST DR
FORT WORTH TX 76179

Officer/Director/Trustee Four

QUYNTON EARLE
SECRETARY
3119 LINCOLN AVE
FORT WORTH TX 76106

Officer/Director/Trustee Five

RACHEL MARTINEZ
PARLIAMENTARIAN
4709 HOMELANDS WAY
FORT WORTH TX 76135

Organization’s website WWW.DHNSYOUTH.ORG
Organization’s email DHNSFOOTBALL@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/30/2010
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O20 - Youth Centers, Clubs, Multipurpose
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
Signature Title
Signature Date

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