FORM 1023-EZ for FALLS CITY YOUTH ASSOCIATION

Field Data
EIN 82-3409864
Case Number EO-2017324-000296
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FALLS CITY YOUTH ASSOCIATION
Organization’s Mailing Address PO BOX 12
City FALLS CITY
State TX
ZIP 78113
Accounting period End 9
Primary contact name JAMES PURCELL JR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAMES PURCELL JR
PRESIDENT, DIRECTOR
530 CR 247
KARNES CITY TX 78118

Officer/Director/Trustee Two

ANNETTE DZIUK
SECRETARY, DIRECTOR
3598 CR 211
HOBSON TX 78117

Officer/Director/Trustee Three

TESSA JURGAJTIS
TREASURER, DIRECTOR
407 NELSON ST
FALLS CITY TX 78113

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/14/2017
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 Yes
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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