FORM 1023-EZ for BUTLER AQUATICS CLUB OHIO

Field Data
EIN 47-4994378
Case Number EO-2017130-000397
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BUTLER AQUATICS CLUB OHIO
Organization’s Mailing Address 5528 FAIR VALLEY ROAD
City DAYTON
State OH
ZIP 45414
Accounting period End 12
Primary contact name JERI LAVIELLE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHAWN GUNCKEL
PRESIDENT
1582 CAMBRON CT
VANDALIA OH 45377

Officer/Director/Trustee Two

JERI LAVIELLE
TREASURER
5528 FAIR VALLEY RD
DAYTON OH 45414

Officer/Director/Trustee Three

TRACY CREWS
VICE PRESIDENT
2322 CRESTRIDGE DR
DAYTON OH 45414

Officer/Director/Trustee Four

NEIL KNUE
OFFICER
1685 FOX RUN
TROY OH 45373

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/25/2016
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N67 - Swimming, Water Recreation
Organization’s purpose Charitable: No
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 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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