FORM 1023-EZ for BUXTON HOLLIS ROD AND GUN CLUB

Field Data
EIN 35-2550726
Case Number EO-2016077-000069
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BUXTON HOLLIS ROD AND GUN CLUB
Organization’s Mailing Address 81 PLAINS ROAD
City HOLLIS CENTER
State ME
ZIP 04042
Accounting period End 12
Primary contact name SHAWN SAGE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SHAWN SAGE
PRESIDENT
84 LOWER TARBOX ROAD
HOLLIS CENTER ME 04042

Officer/Director/Trustee Two

RAY NOEL
TREASURER
8 KELLY LANE
WEST BUXTON ME 04093

Officer/Director/Trustee Three

NANCY LOUNSBURY
SECRETARY
189 PLEASANT HILL ROAD
HOLLIS CENTER ME 04042

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/19/1939
Organization Incorporation State ME
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N61 - Fishing, Hunting Clubs
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
Signature Title
Signature Date

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