FORM 1023-EZ for UKIAH WRESTLING CLUB INC

Field Data
EIN 47-5448555
Case Number EO-2016109-000140
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name UKIAH WRESTLING CLUB INC
Organization’s Mailing Address PO BOX 1354
City UKIAH
State CA
ZIP 95482
Accounting period End 8
Primary contact name THOMAS FRAGOZA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

THOMAS FRAGOZA
PRESIDENT
435 N BUSH ST
UKIAH CA 95482

Officer/Director/Trustee Two

JIMMY PAYNE
VICE PRESIDENT
167 MAGNOLIA ST
UKIAH CA 95482

Officer/Director/Trustee Three

STEPHANIE DUNKEN
TREASURER
8686 EAST RD SPC 45
REDWOOD VALLEY CA 95470

Officer/Director/Trustee Four

ANGELA FRAGOZA
SECRETARY
435 N BUSH ST
UKIAH CA 95482

Officer/Director/Trustee Five

JOHN ESCAMILLA
COACHES REPRESENTATIVE
102 CANYON DR
UKIAH CA 95482

Organization’s website
Organization’s email UKIAHWRESTLINGCLUB@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/17/2015
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N50 - Recreational, Pleasure, or Social Club
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 Yes
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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