FORM 1023-EZ for JAVELINA CHASE INC

Field Data
EIN 82-2417233
Case Number EO-2017230-000218
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name JAVELINA CHASE INC
Organization’s Mailing Address P O BOX 551
City DUNCAN
State AZ
ZIP 85534
Accounting period End 12
Primary contact name JOHN LIEBERENZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DOUGLAS BARLOW
CHAIR
P O BOX 964
DUNCAN AZ 85534

Officer/Director/Trustee Two

JOHN LIEBERENZ
VICE CHAIR
485 STATE ROUTE 92
VIRDEN NM 88045

Officer/Director/Trustee Three

VALERIE SMITH
TREASURER
PO BOX 638
DUNCAN AZ 85534

Officer/Director/Trustee Four

CHRISTA CLOUSE
SECRETARY
3 STATE ROUTE 92
VIRDEN NM 88045

Organization’s website JAVELINACHASE.COM
Organization’s email JAVELINACHASEAZ@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/31/2017
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N99 - Recreation, Sports, Leisure, Athletics N.E.C.
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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