FORM 1023-EZ for CLAY BEARS CLAIMING LOCAL AREA YOUTH INC

Field Data
EIN 46-4746354
Case Number EO-2015180-000352
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CLAY BEARS CLAIMING LOCAL AREA YOUTH INC
Organization’s Mailing Address 271 GLENLYON DRIVE
City ORANGE PARK
State FL
ZIP 32073
Accounting period End 12
Primary contact name CHAD SHULTZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DEREK NEAL
PRESIDENT
271 GLENLYON DR
ORANGE PARK FL 32073

Officer/Director/Trustee Two

JOCGUA KEETON
VICE PRESIDENT
3824 SWEETBRIAR DR
ORANGE PARK FL 32073

Officer/Director/Trustee Three

JAMIE NEAL
SECRETARY TREASURER
271 GLENLYON DR
ORANGE PARK FL 32073

Organization’s website HTTP://WWW.CLAYBEARS.ORG/
Organization’s email DEREKNEAL@COMCAST.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/29/2014
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N65 - Football Clubs, Leagues
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 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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