FORM 1023-EZ for KINGSBURG ATHLETIC FOUNDATION

Field Data
EIN 61-1781805
Case Number EO-2016204-000210
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KINGSBURG ATHLETIC FOUNDATION
Organization’s Mailing Address 3796 AVENUE 408
City KINGSBURG
State CA
ZIP 93631-9620
Accounting period End 12
Primary contact name POLLY BREMEL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RANDY MORRIS
PRES/CHAIRMAN
1900 18TH AVENUE
KINGSBURG CA 93631

Officer/Director/Trustee Two

THOM SEMBRITZKI
VICE PRES
2261 KAMM AVENUE
KINGSBURG CA 93631

Officer/Director/Trustee Three

RYAN PHELAN
SECRETARY
2311 SIERRA STREET
KINGSBURG CA 93631

Officer/Director/Trustee Four

PAULA BREMEL
TREASURER
3796 AVENUE 408
KINGSBURG CA 93631-9620

Organization’s website
Organization’s email POLLY_B@HUGHES.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/4/2016
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N40 - Sports Training Facilities, Agencies
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 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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