FORM 1023-EZ for EUGENE MIDDLE SCHOOL ULTIMATE

Field Data
EIN 47-5010077
Case Number EO-2015336-000349
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name EUGENE MIDDLE SCHOOL ULTIMATE
Organization’s Mailing Address 436 WEST 21ST AVENUE
City EUGENE
State OR
ZIP 97405
Accounting period End 4
Primary contact name RUSSELL ARKIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

RUSSELL ARKIN
EXECUTIVE DIRECTOR
436 WEST 21ST AVENUE
EUGENE OR 97405

Officer/Director/Trustee Two

JARED WEYBRIGHT
BOARD PRESIDENT
557 WEST 27TH PLACE
EUGENE OR 97405

Officer/Director/Trustee Three

JAY JANIN
BOARD VICE PRESIDENT
2677 ONYX ST
EUGENE OR 97403

Officer/Director/Trustee Four

KATHRYN SMITH
BOARD TREASURER
5260 SENGER LANE
EUGENE OR 97405

Officer/Director/Trustee Five

JENNIFER THOENNES
BOARD SECRETARY
1444 E 21ST AVE
EUGENE OR 97403

Organization’s website EMSULTIMATE.COM
Organization’s email EUGENEMSULTIMATE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/13/2015
Organization Incorporation State OR
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: 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 Yes
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
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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