FORM 1023-EZ for GREATER SAMPSON AQUATICS TEAM

Field Data
EIN 83-2067311
Case Number EO-2018280-000102
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GREATER SAMPSON AQUATICS TEAM
Organization’s Mailing Address PO BOX 538
City CLINTON
State NC
ZIP 28329
Accounting period End 12
Primary contact name VALERIE MILLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

VALERIE MILLER
PRESIDENT
249 CHALLENGE CLUB DR
CLINTON NC 28328

Officer/Director/Trustee Two

CHRIS HARDISON
PRESIDENT ELECT
306 FOX LAKE DR
CLINTON NC 28328

Officer/Director/Trustee Three

SUSAN WESTERBEEK
TREASURER
306 DEER TRACK TRAIL
CLINTON NC 28328

Officer/Director/Trustee Four

LESLIE MATTHIS
BOARD OF DIRECTORS
3057 UNION SCHOOL ROAD
CLINTON NC 28328

Officer/Director/Trustee Five

JOHN PENDELL
BOARD OF DIRECTORS
405 SUNSET AVENUE
CLINTON NC 28328

Organization’s website N/A
Organization’s email GSATSWIMMING@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/26/18
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N67 - Swimming, Water Recreation
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name SUSAN WESTERBEEK
Signature Title TREASURER
Signature Date 10/3/18

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