FORM 1023-EZ for RIVERTON YOUTH SOCCER ASSOCIATION

Field Data
EIN 83-0310200
Case Number EO-2021165-000283
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name RIVERTON YOUTH SOCCER ASSOCIATION
Organization’s Mailing Address PO BOX 1504
City RIVERTON
State WY
ZIP 82501
Accounting period End 12
Primary contact name JOSH SALTSGAVER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOSH SALTSGAVER
PRESIDENT
1015 SHERRY DRIVE
RIVERTON WY 82501

Officer/Director/Trustee Two

BRANDON KINTZLER
VICE PRESIDENT
1518 GANNETT DRIVE
RIVERTON WY 82501

Officer/Director/Trustee Three

DEBBIE GRAHAM
TREASURER
4450 LECLAIR LANE
RIVERTON WY 82501

Organization’s website WWW.RIVERTONSOCCER.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/8/1991
Organization Incorporation State WY
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: 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 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 No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name DEBBIE GRAHAM
Signature Title TREASURER
Signature Date 6/10/2021
EIN 83-0310200
Case Number EO-2017317-000675
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name RIVERTON YOUTH SOCCER ASSOCIATION
Organization’s Mailing Address PO BOX 1504
City RIVERTON
State WY
ZIP 82501
Accounting period End 12
Primary contact name JEREMY MEJORADO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JEREMY MEJORADO
PRESIDENT
1740 RIVERVIEW RD
RIVERTON WY 82501

Officer/Director/Trustee Two

DEBBIE GRAHAM
TREASURER
840 COUNTRY CLUB DR
RIVERTON WY 82501

Officer/Director/Trustee Three

JOSHUA SALTSGAVER
FUNDRAISING COORDINATOR
1015 SHERRY DR
RIVERTON WY 82501

Officer/Director/Trustee Four

MELISSA GOLD
SECRETARY
33 COUNTRY ACRES
RIVERTON WY 82501

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/8/1991
Organization Incorporation State WY
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: 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 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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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