FORM 1023-EZ for COUGARS KIDS WRESTLING CLUB

Field Data
EIN 83-2497551
Case Number EO-2019035-000161
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name COUGARS KIDS WRESTLING CLUB
Organization’s Mailing Address 5924 EARNSHAW ST
City SHAWNEE
State KS
ZIP 66216
Accounting period End 12
Primary contact name JERAMY JACKSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JERAMY JACKSON
PRESIDENT
5924 EARNSHAW ST
SHAWNEE KS 66216

Officer/Director/Trustee Two

ZAK KOLICH
VICE- PRESIDENT
13411 W 74TH ST
SHAWNEE KS 66216

Officer/Director/Trustee Three

MELISSA JACKSON
TREASUER
5924 EARNSHAW ST
SHAWNEE KS 66216

Officer/Director/Trustee Four

RACHINDA CARAWAY
SECRETARY
6739 LACKMAN RD APT 204
SHAWNEE KS 66217

Officer/Director/Trustee Five

TOM KIRKPATRICK
SGT OF ARMS
907 169TH ST
BASEHOR KS 66007

Organization’s website
Organization’s email SMNWKIDSCLUB@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/1/18
Organization Incorporation State KS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 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 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 RACHINDA CARAWAY
Signature Title SECRETARY
Signature Date 1/10/19

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