FORM 1023-EZ for COURTHOUSE AND JAIL ROCK GOLF FOUNDATION

Field Data
EIN 82-5246290
Case Number EO-2018130-000600
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name COURTHOUSE AND JAIL ROCK GOLF FOUNDATION
Organization’s Mailing Address 9732 HIGHWAY 26
City BRIDGEPORT
State NE
ZIP 69336
Accounting period End 12
Primary contact name TRAVIS RODAK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANDREW PLUMMER
OFFICER
9732 HIGHWAY 26
BRIDGEPORT NE 69336

Officer/Director/Trustee Two

HAL FISHER
OFFICER
922 S STREET
BRIDGEPORT NE 69336

Officer/Director/Trustee Three

CASSANDRA LAPASEOTES
OFFICER
9744 HIGHWAY 26
BRIDGEPORT NE 69336

Officer/Director/Trustee Four

TRAVIS RODAK
OFFICER
514 MAIN STREET
BRIDGEPORT NE 69336

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/19/18
Organization Incorporation State NE
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: 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 TRAVIS RODAK
Signature Title OFFICER
Signature Date 5/8/18

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