FORM 1023-EZ for ADK TRI CLUB INC

Field Data
EIN 81-2195820
Case Number EO-2017250-000220
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ADK TRI CLUB INC
Organization’s Mailing Address PO BOX 62
City GLENS FALLS
State NY
ZIP 12801
Accounting period End 12
Primary contact name TODD EICHER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TODD EICHER
TREASURER
32 BERRY DRIVE
QUEENSBURY NY 12804

Officer/Director/Trustee Two

HEIDI UNDERWOOD
PRESIDENT
51 LAKEWOOD DRIVE
KATSKILL BAY NY 12844

Officer/Director/Trustee Three

REBECCA EVANSKY
VICE PRESIDENT
222 PERKINS AVE EXT
HUDSON FALLS NY 12839

Officer/Director/Trustee Four

ISABELLE DICKENS
SECRETARY
42 STEWART AVENUE
SOUTH GLENS FALLS NY 12803

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/23/2016
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N70 - Amateur Sports Competitions
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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