FORM 1023-EZ for COMBAT VETERANS MOTORCYCLE ASSOCIATION 12-4

Field Data
EIN 47-4939400
Case Number EO-2016190-000131
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name COMBAT VETERANS MOTORCYCLE ASSOCIATION 12-4
Organization’s Mailing Address 5433 HONEYLEAF WAY
City DAYTON
State OH
ZIP 45424
Accounting period End 12
Primary contact name BEN HEATH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BEN HEATH
COMMANDER
5433 HONEYLEAF WAY
DAYTON OH 45424

Officer/Director/Trustee Two

EDWARD MIECHEK
EXECUTIVE OFFICER
17 FAIR AVE
MEDWAY OH 45341

Officer/Director/Trustee Three

JOE RAYBURN
TRESURER
27 SCHNEIDER DRIVE
FAIRBORN OH 45324

Officer/Director/Trustee Four

ERIC LAROTUNDA
SECRETARY
5410 HONEYLEAF WAY
DAYTON OH 45424

Officer/Director/Trustee Five

KYLE MCGUAGHTRY
SGT AT ARMS
1968 CAROL PARKWAY
KETTERING OH 45440

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/3/2016
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W30 - Military, Veterans' Organizations
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
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
Signature Title
Signature Date

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