FORM 1023-EZ for BIRMINGHAM ULTIMATE YOUTH ASSOCIATION

Field Data
EIN 47-3275301
Case Number EO-2015099-000423
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BIRMINGHAM ULTIMATE YOUTH ASSOCIATION
Organization’s Mailing Address PO BOX 59753
City BIRMINGHAM
State AL
ZIP 35259-9753
Accounting period End 12
Primary contact name DOUG MOELLERING
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LEE LAVETTE
DIRECTOR AND PRESIDENT
807 WINGATE CIRCLE
BIRMINGHAM AL 35209-5225

Officer/Director/Trustee Two

RIC SJOSTROM
DIRECTOR AND TREASURER
1848 RUSSET HILL CIRCLE
BIRMINGHAM AL 35244-8297

Officer/Director/Trustee Three

PAUL DORSEY
DIRECTOR AND SECRETARY
901 IRVING ROAD
BIRMINGHAM AL 35209-3425

Officer/Director/Trustee Four

DOUGLAS MOELLERING
DIRECTOR AND VICE-PRESIDENT
679 RIDGE TOP CIR
BIRMINGHAM AL 35206-1600

Officer/Director/Trustee Five

JASON YEAROUT
DIRECTOR
3300 CAHABA ROAD
BIRMINGHAM AL 35223-2623

Organization’s website WWW.GOBUYA.ORG
Organization’s email LEELAVETTE@CHARTER.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/4/2015
Organization Incorporation State AL
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: Yes
Educational: Yes
Scientific: Yes
Literary: Yes
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 Yes
One Third Support Gifts No
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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