FORM 1023-EZ for WEST TEXAS SPORTS MEDICINE SOCIETY

Field Data
EIN 81-3927990
Case Number EO-2018010-000173
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name WEST TEXAS SPORTS MEDICINE SOCIETY
Organization’s Mailing Address PO BOX 94302
City LUBBOCK
State TX
ZIP 79493-4302
Accounting period End 12
Primary contact name WILLIAM KELLY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

WILLIAM KELLY
PRESIDENT
5602 GENEVA AVE
LUBBOCK TX 79413

Officer/Director/Trustee Two

KIMBER RODGERS
VICE PRESIDENT
416 PRIMROSE AVE
LUBBOCK TX 79416

Officer/Director/Trustee Three

ERICA KELLY KELLY
SECRETARY
5602 GENEVA AVE
LUBBOCK TX 79413

Officer/Director/Trustee Four

SARA KERNS
TREASURER
3808 37TH ST
LUBBOCK TX 79413

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/7/16
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B03 - Professional Societies, Associations
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 Yes
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 WILLIAM KELLY
Signature Title PRESIDENT
Signature Date 1/8/18

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