FORM 1023-EZ for TRI-COUNTY YOUTH SPORTS

Field Data
EIN 47-2280766
Case Number EO-2015051-000050
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TRI-COUNTY YOUTH SPORTS
Organization’s Mailing Address 10316 170TH AVE
City KESWICK
State IA
ZIP 50136
Accounting period End 12
Primary contact name DARA FISHER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DARA FISHER
PRESIDENT
10316 170TH AVE
KESWICK IA 50136

Officer/Director/Trustee Two

MEGAN CHITTICK
SECRETARY
17673 242ND AVE
HARPER IA 52231

Officer/Director/Trustee Three

JILL HALL
VICE-PRESIDENT
20847 138TH ST
WEBSTER IA 52355

Officer/Director/Trustee Four

CHELSEA MOLYNEUX
TREASURER
11921 140TH ST
WHAT CHEER IA 50268

Officer/Director/Trustee Five

KANDI HULL
BOARD MEMBER
1353 YALE AVE
BARNES CITY IA 50027

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/1/2014
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N20 - Recreational and Sporting Camps
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 No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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