FORM 1023-EZ for FAST BREAK BASKETBALL CLUB

Field Data
EIN 81-3152122
Case Number EO-2016236-000122
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FAST BREAK BASKETBALL CLUB
Organization’s Mailing Address 162 NORTH 400 EAST STE A202
City ST GEORGE
State UT
ZIP 84770
Accounting period End 12
Primary contact name DAVID C LEAVITT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MATTHEW HAMBLIN
PRESIDENT
768 S COVEY LANE
SANTA CLARA UT 84765

Officer/Director/Trustee Two

CHRISTOPHER HOWARD
VICE-PRESIDENT
1501 BOYS POND CIRCE
SANTA CLARA UT 84765

Officer/Director/Trustee Three

DAVID LEAVITT
TREASURER
162 N 400 E STE A202
ST GEORGE UT 84770

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/6/2016
Organization Incorporation State UT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, 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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