FORM 1023-EZ for UNIONTOWN ATHLETIC CLUB

Field Data
EIN 81-3246153
Case Number EO-2016312-000291
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name UNIONTOWN ATHLETIC CLUB
Organization’s Mailing Address 10201 BARCELONA RD P O BOX 518
City UNIONTOWN
State AR
ZIP 72955
Accounting period End 6
Primary contact name KARESSA HALEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JESSE FERGUSON
PRESIDENT
3517 PHILADELPHIA RD
VAN BUREN AR 72956-7304

Officer/Director/Trustee Two

KYLE IRVIN
VICE PRESIDENT
7431 UNIONTOWN HWY
VAN BUREN AR 72956-8213

Officer/Director/Trustee Three

KARESSA HALEY
SECRETARY TREASURER
5035 NORTH RUDY RD
RUDY AR 72952-9567

Officer/Director/Trustee Four

NANCY HOSIER
AT LARGE
P O BOX 323
UNIONTOWN AR 72955-0323

Officer/Director/Trustee Five

BRIAN FLEMING
AT LARGE
8914 FRONTIER DR
VAN BUREN AR 72956-9090

Organization’s website
Organization’s email UNIONTOWNATHLETICCLUB@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/10/2016
Organization Incorporation State AR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, 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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