FORM 1023-EZ for CHIPPEWA BAY COMMUNITY CLUB

Field Data
EIN 16-1526525
Case Number EO-2015254-000347
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CHIPPEWA BAY COMMUNITY CLUB
Organization’s Mailing Address PO BOX 116
City CHIPPEWA BAY
State NY
ZIP 13623
Accounting period End 12
Primary contact name VALERIE JOHNSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MARY HAMILTON
PRESIDENT
PO BOX 116
CHIPPEWA BAY NY 13623

Officer/Director/Trustee Two

ALLAN NEWELL
VICE PRESIDENT
PO BOX 116
CHIPPEWA BAY NY 13623

Officer/Director/Trustee Three

JEAN PAPKE
SECRETARY
PO BOX 116
CHIPPEWA BAY NY 13623

Officer/Director/Trustee Four

VALERIE JOHNSON
TREASURER
PO BOX 116
CHIPPEWA BAY NY 13623

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/21/1997
Organization Incorporation State
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural Organizations - Multipurpose
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 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
Signature Title
Signature Date

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