FORM 1023-EZ for YADKIN STARS AND YADKIN BOYS LIVINGHISTORY ASSOCIATION

Field Data
EIN 47-4060516
Case Number EO-2015159-000455
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name YADKIN STARS AND YADKIN BOYS LIVINGHISTORY ASSOCIATION
Organization’s Mailing Address 133 WALNUT AVENUE
City YADKINVILLE
State NC
ZIP 27055
Accounting period End 12
Primary contact name JEFFREY FRANK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JOHN BAUCOM
PRESIDENT
3745 LONE HICKORY ROAD
HAMPTONVILLE NC 27020

Officer/Director/Trustee Two

GREGORY CHEEK
TREASURER
133 WALNUT AVENUE
YADKINVILLE NC 27055

Officer/Director/Trustee Three

STEPHEN HARRIS
CHAIRMAN OF THE BOARD
3411 KENDALE AVENUE NW
CONCORD NC 28027

Officer/Director/Trustee Four

JEFFREY FRANK
DIRECTOR
5403 WOODVINE DRIVE
MCLEANSVILLE NC 27301

Officer/Director/Trustee Five

BRIAN DUCKWORTH
DIRECTOR
620 MARIPOSA ROAD
STANLEY NC 28164

Organization’s website WWW.28THNCT.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/21/2012
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A80 - Historical Societies, Related Historical Activities
Organization’s purpose Charitable: No
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 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 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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