FORM 1023-EZ for CREW CLUB AT NC STATE

Field Data
EIN 46-5168830
Case Number EO-2016095-000374
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CREW CLUB AT NC STATE
Organization’s Mailing Address 2611 CATES AVENUE CAMPUS BOX 8111
City RALEIGH
State NC
ZIP 27695
Accounting period End 12
Primary contact name HAROLD SLAUGHTER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

GRACE JORDAN
PRESIDENT
2021 MONTEGO COURT
RALEIGH NC 27603

Officer/Director/Trustee Two

HAROLD SLAUGHTER
VICE PRESIDENT
102 SHADOW LANE
OXFORD NC 27565

Officer/Director/Trustee Three

KENNY EMERY
TREASURER
3206 TROPICAL SKY LANE
RALEIGH NC 27603

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/30/2014
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B80 - Student Services, Organizations of Students
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 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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