FORM 1023-EZ for PATRIOT SPORTS CLUB

Field Data
EIN 47-4788211
Case Number EO-2015238-000182
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PATRIOT SPORTS CLUB
Organization’s Mailing Address 13207 N HOME RD
City LIBERTY
State MO
ZIP 64068-8186
Accounting period End 12
Primary contact name GARY WILLIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

GARY WILLIS
PRESIDENT
13207 N HOME RD
LIBERTY MO 64068-8186

Officer/Director/Trustee Two

RUSHELLE WILLIS
VICE PRESIDENT
13207 N HOME RD
LIBERTY MO 64068-8186

Officer/Director/Trustee Three

DEANNA FRIDELL
SECRETARY
13106 JAMI DRIVE
KANSAS CITY MO 64166-1071

Officer/Director/Trustee Four

TRUDY WILLIS
TREASURER
6219 NE 120TH STREET
KANSAS CITY MO 64166-1012

Organization’s website HTTP://WWW.PATRIOTSPORTSCLUB.COM/ABOUT.HTML
Organization’s email GARY@PATRIOTSPORTSCLUB.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/13/2015
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O20 - Youth Centers, Clubs, Multipurpose
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 Yes
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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