FORM 1023-EZ for SOUTH CAPROCK YOUTH ASSOCIATION

Field Data
EIN 84-3309229
Case Number EO-2019288-000370
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SOUTH CAPROCK YOUTH ASSOCIATION
Organization’s Mailing Address 905 18TH STREET
City SEAGRAVES
State TX
ZIP 79359
Accounting period End 12
Primary contact name JOHN HOLLIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOHN HOLLIS
PRESIDENT
905 18TH STREET
SEAGRAVES TX 79359

Officer/Director/Trustee Two

LISA MELCHER
VICE PRESIDENT
905 18TH STREET
SEAGRAVES TX 79359

Officer/Director/Trustee Three

LOMA MELCHER
SECRETARY
905 18TH STREET
SEAGRAVES TX 79359

Organization’s website
Organization’s email SOUTHCAPROCKYOUTH@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/9/19
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: No
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 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 JOHN HOLLIS
Signature Title PRESIDENT
Signature Date 10/11/19

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