FORM 1023-EZ for HUMBOLDT RIVER DISC GOLF CLUB

Field Data
EIN 85-3390038
Case Number EO-2020300-000646
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HUMBOLDT RIVER DISC GOLF CLUB
Organization’s Mailing Address 1918 SIERRA DRIVE
City ELKO
State NV
ZIP 89801-4500
Accounting period End 12
Primary contact name MICHAEL BROYLES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHAEL BROYLES
CLUB SECRETARY
1918 SIERRA DRIVE
ELKO NV 89801-4500

Officer/Director/Trustee Two

SCOTT BURT
CLUB PRESIDENT
144 GLEN BRIER DRIVE
SPRING CREEK NV 89815-5739

Officer/Director/Trustee Three

KEITH BESHEA
CLUB TREASURER
1388 ARROYO SECO CIRCLE
ELKO NV 89801-7900

Organization’s website
Organization’s email ELKODISCGOLF@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/1/2020
Organization Incorporation State NV
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N50 - Recreational, Pleasure, or Social Club
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 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 MICHAEL BROYLES
Signature Title CLUB SECRETARY
Signature Date 10/23/2020

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