FORM 1023-EZ for INTERNATIONAL OUTDOOR ADVENTURE INCORPORATED

Field Data
EIN 47-3634911
Case Number EO-2018274-000485
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name INTERNATIONAL OUTDOOR ADVENTURE INCORPORATED
Organization’s Mailing Address 677 GUM CREEK ROAD
City OXFORD
State GA
ZIP 30054
Accounting period End 12
Primary contact name BOBBY BATES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TRACEY BATES
CHAIRMAN
677 GUM CREEK ROAD
OXFORD GA 30054

Officer/Director/Trustee Two

KENNETH LEE BROWN
TREASURER
3030 PREACHER MOON ROAD
CONYERS GA 30012

Officer/Director/Trustee Three

JAME J POLACK
SECRETARY
60 LEGACY WAY
OXFORD GA 30054

Officer/Director/Trustee Four

BENJAMIN MICHAEL POOLE
MEMBER
1626 SOCIAL CIRCLE/FAIRPLAY ROAD
SOCIAL CIRCLE GA 30025

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/9/15
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name TRACEY BATES
Signature Title CHAIRMAN
Signature Date 9/29/18
EIN 47-3634911
Case Number EO-2015191-000365
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name INTERNATIONAL OUTDOOR ADVENTURE INCORPORATED
Organization’s Mailing Address 677 GUM CREEK ROAD
City OXFORD
State GA
ZIP 30054
Accounting period End 12
Primary contact name BOBBY BATES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TRACEY BATES
CHAIRMAN
677 GUM CREEK ROAD
OXFORD GA 30054

Officer/Director/Trustee Two

KENNETH LEE BROWN
TREASURER
3030 PREACHER MOON ROAD
CONYERS GA 30012

Officer/Director/Trustee Three

JAMES J POLACK
SECRETARY
60 LEGACY WAY
OXFORD GA 30054

Officer/Director/Trustee Four

BENJAMIN MICHAEL POOLE
MEMBER
1626 SOCIAL CIRCLE/FAIRPLAY ROAD
SOCIAL CIRCLE GA 30025

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/9/2015
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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
Signature Title
Signature Date

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