FORM 1023-EZ for HILL CITY YOUTH ATHLETICS

Field Data
EIN 81-4118134
Case Number EO-2016292-000164
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HILL CITY YOUTH ATHLETICS
Organization’s Mailing Address PO BOX 934
City KEYSTONE
State SD
ZIP 57751-0934
Accounting period End 12
Primary contact name TRAVIS ECKERT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TRAVIS ECKERT
PRESIDENT
9347 NECK YOKE RD
RAPID CITY SD 57702-7309

Officer/Director/Trustee Two

LARAMIE HARVEY
DIRECTOR
264 MARYBETH CT
HILL CITY SD 57745-3111

Officer/Director/Trustee Three

BLAKE GARDNER
DIRECTOR
441 LACYS CT
HILL CITY SD 57745-6574

Officer/Director/Trustee Four

JACOB RAPP
DIRECTOR
1008 NELSON AVE
KEYSTONE SD 57751-7706

Officer/Director/Trustee Five

CORI SCHMIDT
DIRECTOR
23836 HWY 385
HILL CITY SD 57745-6517

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/23/2016
Organization Incorporation State SD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N99 - Recreation, Sports, Leisure, Athletics N.E.C.
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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
Signature Title
Signature Date

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