FORM 1023-EZ for PELL CITY FUTBOL CLUB

Field Data
EIN 84-2919744
Case Number EO-2019249-000166
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PELL CITY FUTBOL CLUB
Organization’s Mailing Address 125 HIGHLAND VIEW DRIVE
City RIVERSIDE
State AL
ZIP 35135
Accounting period End 12
Primary contact name CHRISTOPHER DEGENER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JASON WOMACK
DIRECTOR
125 HIGHLAND VIEW DRIVE
RIVERSIDE AL 35135

Officer/Director/Trustee Two

SHANE BELL
DIRECTOR
45 FISH TRAP ROAD
CROPWELL AL 35054

Officer/Director/Trustee Three

SHANNON WOMACK
DIRECTOR
125 HIGHLAND VIEW DRIVE
RIVERSIDE AL 35135

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/3/19
Organization Incorporation State AL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N64 - Soccer Clubs, Leagues
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 JASON WOMACK
Signature Title DIRECTOR
Signature Date 9/4/19

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