FORM 1023-EZ for YADKIN CIVIC CLUB INC

Field Data
EIN 86-2272385
Case Number EO-2021093-000150
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name YADKIN CIVIC CLUB INC
Organization’s Mailing Address 2348 OLD US 421 HWY W
City YADKINVILLE
State NC
ZIP 27055
Accounting period End 12
Primary contact name JERRY CARLTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JERRY CARLTON
CHARMAN OF BOARD
2340 W OLD HWY 421
YADKINVILLE NC 27055

Officer/Director/Trustee Two

SANDIE GRANT
PRESIDENT
2737 OLD STAGE RD
YADKINVILE NC 27055

Officer/Director/Trustee Three

REBECCA HARRIS
TRESURER
2838 IRELAND RD
YADKINVILLE NC 27055

Officer/Director/Trustee Four

CRYSTAL WATKINS
DIRECTOR
2424 COURTNEY HUNTSVILLE RD
YADKINVILLE NC 27055

Officer/Director/Trustee Five

JANE LONG
DIRECTOR
2248 OLD US HWY 421 W
YADKINVILLE NC 27055

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/24/2021
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T12 - Fund Raising and/or Fund Distribution
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 JERRY CARLTON
Signature Title CHARMAN OF BOARD
Signature Date 2/26/2021

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