FORM 1023-EZ for CLUB FORTY-FOUR INC

Field Data
EIN 61-1713755
Case Number EO-2018064-000100
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CLUB FORTY-FOUR INC
Organization’s Mailing Address PO BOX 61
City SEWAREN
State NJ
ZIP 7077
Accounting period End 12
Primary contact name DAVID L TEN BROECK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

THOMAS J DRZEWINSKI
PRESIDENT
2340 KNAPP DR
RAHWAY NJ 7065

Officer/Director/Trustee Two

GEORGE REILLY
VICE PRESIDENT
89 BROADWAY AVE
COLONIA NJ 7067

Officer/Director/Trustee Three

DAVID L TEN BROECK
TREASURER
8 LENHOME DR
CRANFORD NJ 7016

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/7/13
Organization Incorporation State NJ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code M40 - Safety Education
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: Yes
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 DAVID L TEN BROECK
Signature Title TREASURER
Signature Date 3/1/18

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