FORM 1023-EZ for CULPEPER KAOS CORP

Field Data
EIN 81-0683699
Case Number EO-2015343-000371
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CULPEPER KAOS CORP
Organization’s Mailing Address 11453 VERGA LN
City BRANDY STATION
State VA
ZIP 22714
Accounting period End 12
Primary contact name TONY CARROLL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TONY CARROLL
PRESIDENT
11453 VERGA LN
BRANDY STATION VA 22714

Officer/Director/Trustee Two

AARON BARLOW
V P
11453 VERGA LN
CULPEPER VA 22714

Officer/Director/Trustee Three

LEE MOORE
OM
11453 VERGA LN
CULPEPER VA 22714

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/5/2015
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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 Yes
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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