FORM 1023-EZ for LAKE TRAVIS HIGH MOUNTAIN BIKE TEAM

Field Data
EIN 45-4550072
Case Number EO-2014363-000273
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LAKE TRAVIS HIGH MOUNTAIN BIKE TEAM
Organization’s Mailing Address 424 DASHER DRIVE
City LAKEWAY
State TX
ZIP 78734
Accounting period End 8
Primary contact name KELLY HEATH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KELLY HEATH
DIRECTOR
424 DASHER DRIVE
LAKEWAY TX 78734

Officer/Director/Trustee Two

SCOT PEMBERTON
HEAD COACH
311 REGATTA COURT UNIT B
LAKEWAY TX 78734

Officer/Director/Trustee Three

MICHAEL SMITH
DIRECTOR
546 BROOKS HOLLOW ROAD
LAKEWAY TX 78734

Officer/Director/Trustee Four

DOUG LANGE
DIRECTOR
15106 SOUTH FLAMINGO
AUSTIN TX 78734

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/16/2012
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N99 - Recreation, Sports, Leisure, Athletics N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 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 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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