FORM 1023-EZ for CENTEVILLE SPECIAL ELK TRACK

Field Data
EIN 47-2420781
Case Number EO-2014346-000240
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CENTEVILLE SPECIAL ELK TRACK
Organization’s Mailing Address 5436 GRANTLAND DR
City DAYTON
State OH
ZIP 45429
Accounting period End 6
Primary contact name MIKE GRIFFIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

J MICHAEL PINEAU
PRESIDENT
6165 MILLBANK DR
DAYTON OH 45459

Officer/Director/Trustee Two

MEGAN SPARKS
VICE PRESIDENT
7625 CLOVERBROOK PARK DR
CENTERVILLE OH 45459

Officer/Director/Trustee Three

MICHAEL GRIFFIS
TREASURE
PO BOX 291823
KETTERING OH 45429

Officer/Director/Trustee Four

DENISE TESEROVITCH
SECRETARY
1527 LANGDON DR
CENTERVILLE OH 45459

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/1/2014
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N72 - Special Olympics
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 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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