FORM 1023-EZ for MODEL HIGH SCHOOL DUGOUT CLUB INC

Field Data
EIN 84-4652808
Case Number EO-2020098-000089
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MODEL HIGH SCHOOL DUGOUT CLUB INC
Organization’s Mailing Address 3252 CALHOUN RD NE
City ROME
State GA
ZIP 30161
Accounting period End 6
Primary contact name JOSEPH NEWBERRY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOSEPH NEWBERRY
PRESIDENT
3252 CALHOUN RD NE
ROME GA 30161

Officer/Director/Trustee Two

KEENA EDWARDS
VICE PRESIDENT
3252 CALHOUN RD NE
ROME GA 30161

Officer/Director/Trustee Three

RODNEY CHASTAIN
TREASURER
3252 CALHOUN RD NE
ROME GA 30161

Officer/Director/Trustee Four

BEN CANTRELL
SECRETARY
3252 CALHOUN RD NE
ROME GA 30161

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/10/2020
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B11 - Single Organization Support
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 JOSEPH NEWBERRY
Signature Title PRESIDENT
Signature Date 4/1/2020

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