FORM 1023-EZ for ONE HUNDRED CLUB OF CORSICANA-NAVARRO COUNTY

Field Data
EIN 20-1962185
Case Number EO-2016202-000283
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ONE HUNDRED CLUB OF CORSICANA-NAVARRO COUNTY
Organization’s Mailing Address P O BOX 491
City CORSICANA
State TX
ZIP 75151
Accounting period End 12
Primary contact name DAVID B NYQUIST
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID B NYQUIST
PRESIDENT
624 EDGEWOOD
CORSICANA TX 75110

Officer/Director/Trustee Two

BRAD HAYNIE
VICE PRESIDENT
1712 CRESTMONT
CORSICANA TX 75110

Officer/Director/Trustee Three

PAT FAIN
TREASURER
800 AMBASSADOR
CORSICANA TX 75110

Officer/Director/Trustee Four

TRACY JOCK
SECRETARY
6075 SECR 2080
CORSICANA TX 75109

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/19/2002
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code I12 - Fund Raising and/or Fund Distribution
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 Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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