FORM 1023-EZ for NORTH DAKOTA YOUTH ARCHERY ADVISORYCOMMITTEE

Field Data
EIN 47-5620295
Case Number EO-2015362-000127
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NORTH DAKOTA YOUTH ARCHERY ADVISORYCOMMITTEE
Organization’s Mailing Address 605 2ND STREET NE
City HANKINSON
State ND
ZIP 58041
Accounting period End 12
Primary contact name JOHN BULLIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

RANDAL BROCKMAN
PRESIDENT
522 5TH ST NW
GWINNER ND 58040

Officer/Director/Trustee Two

GAYLORD HIBL
VICE PRESIDENT
1341 SPRUCE DR
WAHPETON ND 58075

Officer/Director/Trustee Three

HEATHER GOROSKI
SECRETARY
524 3RD STREET NORTH
WAHPETON ND 58075

Officer/Director/Trustee Four

JOSEPH O MEARA
TREASURER
605 2ND STREET NE
HANKINSON ND 58041

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/19/2015
Organization Incorporation State ND
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 Yes
One Third Support Gifts No
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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