FORM 1023-EZ for ALASKA YOUTH RUGBY CLUB

Field Data
EIN 47-4436828
Case Number EO-2021105-000306
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ALASKA YOUTH RUGBY CLUB
Organization’s Mailing Address 4119 LAUREL STREET
City ANCHORAGE
State AK
ZIP 99508
Accounting period End 12
Primary contact name DAVID DELOZIER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID DELOZIER
PRESIDENT
4119 LAUREL STREET
ANCHORAGE AK 99508

Officer/Director/Trustee Two

JAMILLA ALMONTE
TREASURER
2817 RAMPART DR
ANCHORAGE AK 99501

Officer/Director/Trustee Three

ROBERT SACKERSON
VICE PRESIDENT
PO BOX 770686
EAGLE RIVER AK 99577

Officer/Director/Trustee Four

KRYSTAL BLAIR
SECRETARY
3404 GREENLAND DR APT 4
ANCHORAGE AK 99517

Officer/Director/Trustee Five

ROBERT VAN ZWEEDEN
DIRECTOR
4119 LAUREL STREET
ANCHORAGE AK 99508

Organization’s website www.rugbyalaska.org
Organization’s email akyouthrugby@gmail.com
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/1/2015
Organization Incorporation State AK
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N50 - Recreational, Pleasure, or Social Club
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 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 KRYSTAL BLAIR
Signature Title SECRETARY
Signature Date 4/13/2021

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