FORM 1023-EZ for CARY ATHLETIC CLUB

Field Data
EIN 84-4401205
Case Number EO-2020214-000008
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CARY ATHLETIC CLUB
Organization’s Mailing Address 11221 EMERALD CREEK DRIVE
City RALEIGH
State NC
ZIP 27617
Accounting period End 12
Primary contact name DEBORAH A MCDERMOTT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CONRAD HALL
PRESIDENT
2823 DEKALB STREET
DURHAM NC 27705

Officer/Director/Trustee Two

BRYAN FISHER
TREASURER
11221 EMERALD CREEK DRIVE
RALEIGH NC 27617

Officer/Director/Trustee Three

SARAH FULK
SECRETARY
506 DEVEREUX STREET
RALEIGH NC 27605

Officer/Director/Trustee Four

NICK KISLEY
DIRECTOR
4528 GILES AVENUE
SHERRILLS FORD NC 28673

Officer/Director/Trustee Five

THOMAS GRAHAM
DIRECTOR
956Y ASHBURY STREET
SAN FRANCISCO CA 94117

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/17/2020
Organization Incorporation State NC
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 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 BRYAN FISHER
Signature Title TREASURER
Signature Date 7/29/2020

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