FORM 1023-EZ for AFFECT CHANGE THROUGH SPORTS INC

Field Data
EIN 85-2919090
Case Number EO-2020321-000343
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name AFFECT CHANGE THROUGH SPORTS INC
Organization’s Mailing Address PO BOX 475
City CLAYTON
State CA
ZIP 94517
Accounting period End 12
Primary contact name MICHAEL ROGERS JR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHAEL ROGERS JR
PRESIDENT/DIRECTOR
5575 JASPER CT
CONCORD CA 94521

Officer/Director/Trustee Two

TRAVIS HAYHURST
TREASURER/DIRECTOR
5575 JASPER CT
CONCORD CA 94521

Officer/Director/Trustee Three

AUSTIN BYLER
SECRETARY/DIRECTOR
5575 JASPER CT
CONCORD CA 94521

Organization’s website HTTP://WWW.ACTSPORTS.ORG
Organization’s email MIKE@ACTSPORTS.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/12/2020
Organization Incorporation State CA
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 Yes
Donation of funds Yes
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 MICHAEL ROGERS JR
Signature Title PRESIDENT/DIRECTOR
Signature Date 11/12/2020

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