FORM 1023-EZ for FLAT TRACK SAFETY GROUP

Field Data
EIN 82-2129445
Case Number EO-2017201-000229
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FLAT TRACK SAFETY GROUP
Organization’s Mailing Address 921 CHURCH ST
City SAN FRANCISCO
State CA
ZIP 94114
Accounting period End 12
Primary contact name RANDY KREMLACEK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RANDY KREMLACEK
PRESIDENT
921 CHURCH ST
SAN FRANCISCO CA 94114

Officer/Director/Trustee Two

BRIAN BARTLOW
SECRETARY/TREASURER
4980 KONOCTI RD
KELSEYVILLE CA 95451

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/11/2017
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N03 - Professional Societies, Associations
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 Yes
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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