FORM 1023-EZ for TANEY COUNTY 100 CLUB

Field Data
EIN 85-3943487
Case Number EO-2021015-000129
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TANEY COUNTY 100 CLUB
Organization’s Mailing Address PO BOX 6091
City BRANSON
State MO
ZIP 65615
Accounting period End 12
Primary contact name CORY A ROEBUCK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CORY ROEBUCK
PRESIDENT
405 MEADOW LANE
BRANSON MO 65616

Officer/Director/Trustee Two

JEFFREY HENDERSON
BOARD MEMBER
139 N TUSCAN DR
HOLLISTER MO 65672

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/11/2020
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code J99 - Employment, Job Related 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 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 No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name CORY ROEBUCK
Signature Title PRESIDENT
Signature Date 11/18/2020

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