FORM 1023-EZ for BE HUMBLE GYM NFP

Field Data
EIN 84-5009063
Case Number EO-2020107-000230
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BE HUMBLE GYM NFP
Organization’s Mailing Address 3 ROYAL DRIVE
City SHERMAN
State IL
ZIP 62684-9765
Accounting period End 12
Primary contact name JORDAN R MATULEVICH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JORDAN MATULEVICH
DIRECTOR -PRESIDENT
3 ROYAL DRIVE
SHERMAN IL 62684-9765

Officer/Director/Trustee Two

LESLIE MATULEVICH
DIRECTOR- TREASURER
3 ROYAL DRIVE
SHERMAN IL 62684-9765

Officer/Director/Trustee Three

SARAH ROBINSON
DIRECTOR - SECRETARY
115 COUNTRY PL
SPRINGFIELD IL 62703-5376

Officer/Director/Trustee Four

STEVE GEYSTON
DIRECTOR - VICE PRESIDENT
270 PARKVIEW DR
SHERMAN IL 62684-8907

Officer/Director/Trustee Five

JULIE BUTLER
DIRECTOR - VICE PRESIDENT
800 MALLARD WAY
SHERMAN IL 62684-9502

Organization’s website
Organization’s email BEHUMBLEGYM@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/25/2020
Organization Incorporation State IL
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: No
Educational: No
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 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 JORDAN MATULEVICH
Signature Title DIRECTOR -PRESIDENT
Signature Date 4/14/2020

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