FORM 1023-EZ for PUMPKIN CREEK COMMUNITY CLUB

Field Data
EIN 82-5287120
Case Number EO-2018128-000870
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PUMPKIN CREEK COMMUNITY CLUB
Organization’s Mailing Address 71 SONNETTE ROAD BOX 121
City BROADUS
State MT
ZIP 59317
Accounting period End 12
Primary contact name ALETTA SHANNON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ALETTA SHANNON
TREASURER
PO BOX 121
BROADUS MT 59317

Officer/Director/Trustee Two

RANDY SHANNON
DIRECTOR
PO BOX 121
BROADUS MT 59317

Officer/Director/Trustee Three

DENNIS LYDA
PRESIDENT
135 15 MILE ROAD
SONNETTE MT 59317

Officer/Director/Trustee Four

TOM EMMONS
DIRECTOR
3 SKINNER GULCH
VOLBORG MT 59351

Officer/Director/Trustee Five

ANN EMMONS
MEMBER
3 SKINNER GULCH
VOLBORG MT 59351

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/23/18
Organization Incorporation State MT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Y99 - Mutual/Membership Benefit Organizations, Other 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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ALETTA SHANNON
Signature Title TREASURER
Signature Date 5/2/18

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