FORM 1023-EZ for ANDERSON INDEPENDENT YOUTH SOCCER ASSOCIATION

Field Data
EIN 61-1092442
Case Number EO-2014254-000590
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ANDERSON INDEPENDENT YOUTH SOCCER ASSOCIATION
Organization’s Mailing Address P O BOX 642
City LAWRENCEBURG
State KY
ZIP 40342
Accounting period End 12
Primary contact name JASON FEDDERSEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MARGARET ADKINS
PRESIDENT
P O BOX 642
LAWRENCEBURG KY 40342

Officer/Director/Trustee Two

JARED TOPPER
VICE PRESIDENT
P O BOX 642
LAWRENCEBURG KY 40342

Officer/Director/Trustee Three

JASON FEDDERSEN
TREASURER
P O BOX 642
LAWRENCEBURG KY 40342

Officer/Director/Trustee Four

DONALD LEATHERS
LEAGUE COORDINATOR
P O BOX 642
LAWRENCEBURG KY 40342

Officer/Director/Trustee Five

RICHARD SHEARER
EQUIPMENT COORDINATOR
P O BOX 642
LAWRENCEBURG KY 40342

Organization’s website WWW.AIYSA.NET
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/19/1983
Organization Incorporation State KY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N64 - Soccer Clubs, Leagues
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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