FORM 1023-EZ for BROKEN BOW SWIM CLUB INC

Field Data
EIN 47-0613689
Case Number EO-2016130-000276
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BROKEN BOW SWIM CLUB INC
Organization’s Mailing Address PO BOX 111
City BROKEN BOW
State NE
ZIP 68822
Accounting period End 12
Primary contact name AMY CYBORON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ROBERTA MESCHKE
PRESIDENT
79957 AIRPORT RD
BROKEN BOW NE 68822

Officer/Director/Trustee Two

AMY CYBORON
TREASURER
44009 LAURAL DRIVE
BROKEN BOW NE 68822

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/13/1978
Organization Incorporation State NE
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 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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