FORM 1023-EZ for ARKANSAS YOUTH PROVIDERS ASSOCIATION INC

Field Data
EIN 30-0062442
Case Number EO-2015168-000193
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ARKANSAS YOUTH PROVIDERS ASSOCIATION INC
Organization’s Mailing Address 4220 STADIUM BLVD
City JONESBORO
State AR
ZIP 72404
Accounting period End 12
Primary contact name DUDLEY S BOWDON CPA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SCOTT LINEBAUGH
PRESIDENT
4171 CROSSOVER ROAD
FAYETTEVILLE AR 72703

Officer/Director/Trustee Two

MADELYN KEITH
VICE PRESIDENT
104 CYPRESS
MARION AR 72364

Officer/Director/Trustee Three

BONNIE SMITH
TREASURER
4220 STADIUM BLVD
JONESBORO AR 72404

Officer/Director/Trustee Four

JOHN FURNESS
SECRETARY
1606 SOUTH J ST
FORT SMITH AR 72901

Officer/Director/Trustee Five

MIKE WORLEY
DIRECTOR
100 S CHEROKEE
MORRILTON AR 72110

Organization’s website NA
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/14/1998
Organization Incorporation State AR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: No
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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