FORM 1023-EZ for BROKEN BOW YOUTH WRESTLING ASSOCIATION

Field Data
EIN 47-5362033
Case Number EO-2016239-000155
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BROKEN BOW YOUTH WRESTLING ASSOCIATION
Organization’s Mailing Address PO BOX 1414
City BROKEN BOW
State OK
ZIP 74728
Accounting period End 4
Primary contact name ERICK WARREN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ERICK WARREN
PRESIDENT, COACH
107 MILES STREET
BROKEN BOW OK 74728

Officer/Director/Trustee Two

DERECK WARREN
VICE-PRESIDENT
408 E SHERRY LANE
BROKEN BOW OK 74728

Officer/Director/Trustee Three

AMANDA THWEATT
TREASURER
801 CIRCLE DRIVE
BROKEN BOW OK 74728

Officer/Director/Trustee Four

CARI MEDDOCK
SECRETARY
804 KEITH STREET
BROKEN BOW OK 74728

Officer/Director/Trustee Five

RIKKI ROBERTS
MEMBER AT LARGE
404 GLOVER SCHOOL ROAD
BROKEN BOW OK 74728

Organization’s website HTTPS://FACEBOOK.COM/B.B.Y.W.A.2015
Organization’s email BROKENBOWYOUTHWRESTLING@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/5/2014
Organization Incorporation State OK
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: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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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