FORM 1023-EZ for SOUTHERN ARIZONA ADAPTIVE SPORTS

Field Data
EIN 82-1289116
Case Number EO-2017116-000311
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SOUTHERN ARIZONA ADAPTIVE SPORTS
Organization’s Mailing Address 2610 E CROYDEN STREET
City TUCSON
State AZ
ZIP 85716
Accounting period End 12
Primary contact name MIA HANSEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MIA HANSEN
DIRECTOR
2610 E CROYDEN STREET
TUCSON AZ 85716

Officer/Director/Trustee Two

MICHAEL ROSENKRANTZ
DIRECTOR
2342 E PARKWAY TERRACE
TUCSON AZ 85719

Officer/Director/Trustee Three

BRANDON ATHEY
DIRECTOR
4280 W GOLDEN RANCH PL
MARANA AZ 85658

Officer/Director/Trustee Four

SUE KROEGER
DIRECTOR
921 E CHULA VISTA ROAD
TUCCSON AZ 85718

Officer/Director/Trustee Five

GABE NYRKKANEN
DIRECTOR
1941 W CALLE CAMPANA DE PLATA
TUCSON AZ 85745

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/24/2017
Organization Incorporation State AZ
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: 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 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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