FORM 1023-EZ for UTAH SURF SOCCER CLUB NORTH

Field Data
EIN 46-3935363
Case Number EO-2015187-000352
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name UTAH SURF SOCCER CLUB NORTH
Organization’s Mailing Address 1622 EAST HEATHERWOOD CIRCLE
City SANDY
State UT
ZIP 84092
Accounting period End 12
Primary contact name ALBERT S TOA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ALBERT TOA
DIRECTOR OF OPERATIONS
1622 HEATHERWOOD CIRCLE
SANDY UT 84092

Officer/Director/Trustee Two

SYLVIA JESSEN
PRESIDENT
8338 SOUTH 1925 EAST
SANDY UT 84093

Organization’s website WWW.SURFSOCCERUTAH.ORG
Organization’s email UTAHSURFSC@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/1/2014
Organization Incorporation State UT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N64 - Soccer Clubs, Leagues
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 Yes
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 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
Signature Title
Signature Date

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