FORM 1023-EZ for DALLAS ULTIMATE STUDENT ATHLETE USA

Field Data
EIN 81-1661534
Case Number EO-2016069-000159
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DALLAS ULTIMATE STUDENT ATHLETE USA
Organization’s Mailing Address 1514 OXFORD DR
City MANSFIELD
State TX
ZIP 76063
Accounting period End 12
Primary contact name ANTHONY TALTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ANTHONY TALTON
PRESIDENT
1514 OXFORD DR
MANSFIELD TX 76063

Officer/Director/Trustee Two

DON CARTER
TRESURER
5509 LONG LEAF
DALLAS TX 75232

Officer/Director/Trustee Three

LESTER WALKER
SEC
7550 ARCADIA TRAIL
FORT WORTH TX 76137

Organization’s website
Organization’s email TSQUARE58@CHARTER.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/2001
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O99 - Youth Development 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 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
Signature Title
Signature Date

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