FORM 1023-EZ for SAN JUAN BASIN DISC GOLF CLUB

Field Data
EIN 85-2737912
Case Number EO-2021078-000820
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SAN JUAN BASIN DISC GOLF CLUB
Organization’s Mailing Address 1309 N MESA VERDE AVE
City FARMINGTON
State NM
ZIP 87401
Accounting period End 12
Primary contact name JAY MAAS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAY MAAS
PRESIDENT
1309 N MESA VERDE AVE
FARMINGTON NM 87401

Officer/Director/Trustee Two

LEO SAMORA
VICE PRESIDENT
1309 N MESA VERDE AVE
FARMINGTON NM 87401

Officer/Director/Trustee Three

STEVE MATTHIAS
TREASURER
1309 N MESA VERDE AVE
FARMINGTON NM 87401

Officer/Director/Trustee Four

CAMERON OTERO
SECRETARY
1309 N MESA VERDE AVE
FARMINGTON NM 87401

Officer/Director/Trustee Five

RANDALL PACE
DIRECTOR
1309 N MESA VERDE AVE
FARMINGTON NM 87401

Organization’s website
Organization’s email JAYMAAS.DEV@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/24/2020
Organization Incorporation State NM
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: 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 Yes
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 JAY MAAS
Signature Title PRESIDENT
Signature Date 1/22/2021

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