FORM 1023-EZ for ARCHERY LA ACADEMY INC

Field Data
EIN 81-2587724
Case Number EO-2016181-000087
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ARCHERY LA ACADEMY INC
Organization’s Mailing Address 801 W COVINA BLVD SPC 169
City SAN DIMAS
State CA
ZIP 91773-2408
Accounting period End 12
Primary contact name ERIC TOLLEFSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ERIC TOLLEFSON
PRESIDENT, TREASURER
801 W COVINA BLVD SPC 169
SAN DIMAS CA 91773-2408

Officer/Director/Trustee Two

ODALIS TOLLEFSON
SECRETARY
801 W COVINA BLVD SPC 169
SAN DIMAS CA 91773-2408

Officer/Director/Trustee Three

JOHN HELGESON
DIRECTOR
801 W COVINA BLVD SPC 169
SAN DIMAS CA 91773-2408

Officer/Director/Trustee Four

ANGELA JOHNSON MESZAROS
DIRECTOR
801 W COVINA BLVD SPC 169
SAN DIMAS CA 91773-2408

Officer/Director/Trustee Five

STEVE ROTH
DIRECTOR
801 W COVINA BLVD SPC 169
SAN DIMAS CA 91773-2408

Organization’s website WWW.ARCHERYLA.COM
Organization’s email ERIC@ARCHERYLA.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/29/2016
Organization Incorporation State CA
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: No
Religious: No
Educational: Yes
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 Yes
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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