FORM 1023-EZ for FORT WAYNE STARS SPORTS AND TRAINING CENTER INC

Field Data
EIN 81-1492330
Case Number EO-2016053-000167
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FORT WAYNE STARS SPORTS AND TRAINING CENTER INC
Organization’s Mailing Address 10211 BASHWOOD PASS
City FORT WAYNE
State IN
ZIP 46804
Accounting period End 12
Primary contact name SCOTT BLACK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SCOTT BLACK
DIRECTOR
720 STORMY RUN LANE
FORT WAYNE IN 46825

Officer/Director/Trustee Two

RANDALL MOSS
DIRECTOR
10211 BASHWOOD PASS
FORT WAYNE IN 46804

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/5/2016
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N40 - Sports Training Facilities, Agencies
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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 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
Signature Title
Signature Date

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