FORM 1023-EZ for COOL BEANS RACING UTAH

Field Data
EIN 82-4620740
Case Number EO-2018064-000425
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name COOL BEANS RACING UTAH
Organization’s Mailing Address 450 WESTFIELD ROAD
City ALPINE
State UT
ZIP 84004
Accounting period End 12
Primary contact name PATTIE S CHRISTENSEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARK ADCOCK
TRUSTEE/DIRECTOR
450 WESTFIELD ROAD
ALPINE UT 84004

Officer/Director/Trustee Two

KAMERON SPENCIER
TRUSTEE/DIRECTOR
14274 S BELMONT RIDGE CIRCLE
DRAPER UT 84020

Officer/Director/Trustee Three

KAMLIN NEDVED
TRUSTEE/DIRECTOR
8240 E 128TH PLACE
THORNTON CO 80602

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/1/18
Organization Incorporation State UT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O20 - Youth Centers, Clubs, Multipurpose
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name MARK ADCOCK
Signature Title TRUSTEE/DIRECTOR
Signature Date 3/2/18

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