FORM 1023-EZ for MUSTANG STAMPEDE XC BOOSTER CLUB INC

Field Data
EIN 47-2174731
Case Number EO-2015035-000197
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MUSTANG STAMPEDE XC BOOSTER CLUB INC
Organization’s Mailing Address P O BOX 3752
City LILBURN
State GA
ZIP 30048
Accounting period End 5
Primary contact name MARY K COUGHLIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

AIMEE WALTHALL
DIRECTOR, COACH, CROSS COUNTRY
310 DUNBAR DRIVE
ATLANTA GA 30338-6545

Officer/Director/Trustee Two

MORIS JOEL ORDONEZ
PRESIDENT
5132 EDINBURG CT
LILBURN GA 30047

Officer/Director/Trustee Three

MARY COUGHLIN
TREASURER
1377 WILLIAMSBURG LANE
Norcross GA 30093

Officer/Director/Trustee Four

ANA EVELIN FUENTES
SECRETARY
5132 EDINBURG CT
LILBURN GA 30093

Officer/Director/Trustee Five

SCOTT BEEMER
HEAD COACH, SOCCER
4455 STEVE REYNOLDS BLVD
NORCROSS GA 30093

Organization’s website
Organization’s email STAMPEDEINTHEPARK@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/13/2014
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N99 - Recreation, Sports, Leisure, Athletics N.E.C.
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 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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