FORM 1023-EZ for MOSSY POND YOUTH SHOTGUN TEAM INC

Field Data
EIN 47-5496077
Case Number EO-2016309-000216
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MOSSY POND YOUTH SHOTGUN TEAM INC
Organization’s Mailing Address 7129 PATTERSON HWY 32
City PATTERSON
State GA
ZIP 31557
Accounting period End 12
Primary contact name BLANE HILL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BLANE HILL
PRESIDENT
7129 HWY 32
PATTERSON GA 31557

Officer/Director/Trustee Two

KELLY DIXON
VICE PRESIDENT
3128 TAYLOR FARM RD
BLACKSHEAR GA 31516

Officer/Director/Trustee Three

SCOTT SAPP
SECRETARY
6620 HWY 32
PATTERSON GA 31557

Organization’s website NONE
Organization’s email MOSSYPONDYST@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/9/2015
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, N.E.C.
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 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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