FORM 1023-EZ for BLAIR YOUTH SHOOTING SPORTS

Field Data
EIN 47-1926206
Case Number EO-2014287-000214
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BLAIR YOUTH SHOOTING SPORTS
Organization’s Mailing Address 15820 COUNTY RD 23
City HERMAN
State NE
ZIP 68029
Accounting period End 12
Primary contact name DENNIS J ZOLCK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DENNIS ZOLCK
PRESIDENT, DIRECTOR
15820 COUNTY RD 23
HERMAN NE 68029

Officer/Director/Trustee Two

DAVID SHEETS
VICE PRESIDENT, DIRECTOR
15231 COUNTY RD P10
BLAIR NE 68008

Officer/Director/Trustee Three

KEVIN KAVANAUGH
SECRETARY, TREASURER, DIRECTOR
10300 CHESHIRE AVENUE
OMAHA NE 68142

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/5/2014
Organization Incorporation State NE
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: 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 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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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