FORM 1023-EZ for DERBY CITY AC INC

Field Data
EIN 81-1187913
Case Number EO-2017137-000403
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DERBY CITY AC INC
Organization’s Mailing Address 307 PEPPERBUSH RD
City LOUISVILLE
State KY
ZIP 40207-5707
Accounting period End 12
Primary contact name JOE BUECHLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOSEPH BUECHLER
PRESIDENT
307 PEPPERBUSH RD
LOUISVILLE KY

Officer/Director/Trustee Two

DAVID FLAUGHER
DIRECTOR
9903 TULIP POPLAR CT
LOUISVILLE KY 40291-3389

Officer/Director/Trustee Three

KENNETH STOTTMAN
DIRECTOR
2104 MAMMOTH WAY
LOUISVILLE KY 40299-2609

Organization’s website
Organization’s email joebuechler62@gmail.com
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/22/2016
Organization Incorporation State KY
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: 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 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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