FORM 1023-EZ for FLH YOUTH CAMP

Field Data
EIN 46-3750441
Case Number EO-2015048-000068
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FLH YOUTH CAMP
Organization’s Mailing Address 13501 SHELTON RD
City MABELVALE
State AR
ZIP 72103
Accounting period End 12
Primary contact name VIRGIL BRIMLEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TERRY WILLIAMS
DIRECTOR
13501 SHELTON RD
MABELVALE AR 72103

Officer/Director/Trustee Two

SAMMY JACKSON
DIRECTOR
13501 SHELTON RD
MABELVALE AR 72103

Officer/Director/Trustee Three

VIRGIL BRIMLEY
COO
13501 SHELTON RD
MABELVALE AR 72103

Officer/Director/Trustee Four

EVEONNE LINDSEY
CONTROLLER
13501 SHELTON RD
MABELVALE AR 72103

Officer/Director/Trustee Five

LINDA BRIMLEY
CFO
13501 SHELTON RD
MABELVALE AR 72103

Organization’s website WWW.FLHYOUTHCAMP.ORG
Organization’s email VIRGIL@AXSCOMPUTING.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/9/2013
Organization Incorporation State AR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O55 - Youth Development - Religious Leadership
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: No
Literary: Yes
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 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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