FORM 1023-EZ for CENTRALTX YOUTH ASSOCIATION

Field Data
EIN 47-3901788
Case Number EO-2015177-000263
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CENTRALTX YOUTH ASSOCIATION
Organization’s Mailing Address P O BOX 4364
City KILLEEN
State TX
ZIP 76540
Accounting period End 12
Primary contact name BERNARD SMALLS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TIMOTHY SENIOR GOSS
PRESIDENT
4902 FAWN DRIVE
KILLEEN TX 76542-4447

Officer/Director/Trustee Two

JUSTIN TILLIS
VICE PRESIDENT
5410 GUNNISON DRIVE
KILLEEN TX 76542-4437

Officer/Director/Trustee Three

BERNARD SMALLS
TREASURER
100 DOC HOLLIDAY DRIVE
NOLANVILLE TX 76559-2504

Officer/Director/Trustee Four

BRAD GRIMES
RECORDER
200 LOTTIE LN
HARKER HEIGHTS TX 76548-7472

Officer/Director/Trustee Five

JOHN E JOHNSON
MARKETING AGENT
485 ROLLING HILLS DR
KILLEEN TX 76543-8045

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/4/2015
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N62 - Basketball
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 No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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