FORM 1023-EZ for RAYNAS CLUBHOUSE INC

Field Data
EIN 87-1273929
Case Number EO-2021223-000457
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name RAYNAS CLUBHOUSE INC
Organization’s Mailing Address 1445 ROYAL LAKE DR
City INDIANAPOLIS
State KS
ZIP 46228-1380
Accounting period End 12
Primary contact name VIVIAN BROOKS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

VIVIAN BROOKS
CEO
1445 ROYAL LAKE DR
INDIANAPOLIS IN 46228-1380

Organization’s website WWW.RAYNASCLUBHOUSE.ORG
Organization’s email RAYNASCLUBHOUSE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/16/2021
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O29 -
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 VIVIAN BROOKS
Signature Title CEO
Signature Date 8/10/2021

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