FORM 1023-EZ for KOUNTZE ATHLETIC ORGANIZATION

Field Data
EIN 84-1952994
Case Number EO-2019192-000371
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KOUNTZE ATHLETIC ORGANIZATION
Organization’s Mailing Address PO BOX 51
City KOUNTZE
State TX
ZIP 77625
Accounting period End 8
Primary contact name BRANDON LAIRD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRANDON LAIRD
PRESIDENT
2670 HWY 326
KOUNTZE TX 77625

Officer/Director/Trustee Two

AMY BEAL
VICE PRESIDENT
132 LINDSEY ST
SILSBEE TX 77656

Officer/Director/Trustee Three

CASSANDRA WALTERS
SECRETARY
955 E WILLIFORD
KOUNTZE TX 77625

Officer/Director/Trustee Four

SHELLIE EVERETT
TREASURE
164 WOODLAND DR
KOUNTZE TX 77625

Officer/Director/Trustee Five

MAURISA FRENCH
BOARD MEMBER
1136 WILDEMEADOW
BEAUMONT TX 77706

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/1/19
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N12 - 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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name BRANDON LAIRD
Signature Title PRESIDENT
Signature Date 7/9/19

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