FORM 1023-EZ for PROVO MTB CYCLING CLUB

Field Data
EIN 82-1174731
Case Number EO-2017107-000206
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PROVO MTB CYCLING CLUB
Organization’s Mailing Address 5280 N CANYON ROAD
City PROVO
State UT
ZIP 84604
Accounting period End 12
Primary contact name BRYAN GILLESPIE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRYAN GILLESPIE
TRUSTEE
5280 N CANYON ROAD
PROVO UT 84604

Officer/Director/Trustee Two

HEATHER GOODWIN NELSON
TRUSTEE
788 E 1740 S
PROVO UT 84097

Officer/Director/Trustee Three

HARRY MCCORD
TRUSTEE
508 N 1480 E
PROVO UT 84606

Officer/Director/Trustee Four

JEANIE BUDGE
TRUSTEE
5240 N CANYON ROAD
PROVO UT 84604

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/13/2017
Organization Incorporation State UT
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 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
Signature Title
Signature Date

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