FORM 1023-EZ for RIVER VALLEY SUPERHERO 5K

Field Data
EIN 46-4381138
Case Number EO-2016032-000355
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name RIVER VALLEY SUPERHERO 5K
Organization’s Mailing Address PO BOX 11722
City RUSSELLVILLE
State AR
ZIP 72812
Accounting period End 6
Primary contact name BRENDA STEPHENSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

BRENDA STEPHENSON
CO-PRESIDENT
200 HOLLOW LANE
RUSSELLVILLE AR 72802

Officer/Director/Trustee Two

TAMARA MARCOE
CO-PRESIDENT
1815 MEADOWBROOK LANE
RUSSELLVILLE AR 72802

Officer/Director/Trustee Three

JAIME KEYS
BOARD MEMBER
399 STONEGATE DRIVE
RUSSELLVILLE AR 72802

Organization’s website WWW.RIVERVALLEYSUPERHERO5K.ORG
Organization’s email RIVERVALLEYSUPERHERO5K@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/12/2015
Organization Incorporation State AR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G12 - Fund Raising and/or Fund Distribution
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 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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