FORM 1023-EZ for SPAVINAW YOUTH CENTER

Field Data
EIN 46-5230672
Case Number EO-2015061-000431
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SPAVINAW YOUTH CENTER
Organization’s Mailing Address POB 41
City SPAVINAW
State OK
ZIP 74366
Accounting period End 12
Primary contact name RUSTY HENSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

RHONDA HENSON
CHAIRMAN
681 ROSS ROAD
SPAVINAW OK 74366

Officer/Director/Trustee Two

AMANDA MILLER
SECRETARY
1306 NE 4TH
PRYOR OK 74361

Officer/Director/Trustee Three

RUSTY HENSON
VICE CHAIRMAN
681 ROSS ROAD
SPAVINAW OK 74366

Officer/Director/Trustee Four

JIMMY MILLER
BOARD MEMBER
1306 NE 4TH
PRYOR OK 74361

Officer/Director/Trustee Five

LORENE SCHALLER
BOARD MEMBER
POB 144
DISNEY OK 74340

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/13/2015
Organization Incorporation State OK
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: Yes
Scientific: No
Literary: Yes
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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