FORM 1023-EZ for ALBIA HIGH SCHOOL CLAY TARGET PROGRAM

Field Data
EIN 83-0544913
Case Number EO-2018253-000554
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ALBIA HIGH SCHOOL CLAY TARGET PROGRAM
Organization’s Mailing Address 2424 601ST TRAIL
City ALBIA
State IA
ZIP 52531-1119
Accounting period End 12
Primary contact name MICHAEL RUNYAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHAEL RUNYAN
HEAD COACH
2424 601ST TRAIL
ALBIA IA 52531-1119

Officer/Director/Trustee Two

ANDY WUEBKER
DIRECTOR MONROE COUNTY CONSERVATION
1270 635THE AVENUE
LOVILIA IA 50150

Officer/Director/Trustee Three

WILLIAM CARLTON
COACH
106 LINDEN LANE
ALBIA IA 52531-1119

Officer/Director/Trustee Four

STEVE HASKINS
COACH
1110 4TH AVENUE EAST
ALBIA IA 52531-1119

Officer/Director/Trustee Five

GARY SCOTT
COACH
2321 HIGHWAY 5
ALBIA IA 52531-1119

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/1/09
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B80 - Student Services, Organizations of Students
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 RUNYAN
Signature Title HEAD COACH
Signature Date 9/8/18

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