FORM 1023-EZ for PEBBLE CREEK AMATEUR RADIO CLUB

Field Data
EIN 46-4173308
Case Number EO-2014251-000565
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PEBBLE CREEK AMATEUR RADIO CLUB
Organization’s Mailing Address 16177 WEST WHITTON AVENUE
City GOODYEAR
State AZ
ZIP 85395
Accounting period End 12
Primary contact name ROBERT SHEETS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ROBERT SHEETS
PRESIDENT
2268 COUNTRY CLUB LOOP
WESTMINSTER CO 80234

Officer/Director/Trustee Two

DENNIS HARDEN
VICE PRESIDENT
12895 WEST ARIZONA PLACE
LAKEWOOD CO 80228

Officer/Director/Trustee Three

CAROL MELTON
SECRETARY
20019 WEST CAMELBACK
LITCHFIELD PARK AZ 85340

Officer/Director/Trustee Four

RONALD LUNDEEN
TREASURER
16177 W WHITTON AVE
GOODYEAR AZ 85395

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/18/2013
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code M99 - Public Safety, Disaster Preparedness, and Relief 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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