FORM 1023-EZ for COLLINS MAXWELL SOCCER CLUB

Field Data
EIN 46-2438925
Case Number EO-2015170-000280
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name COLLINS MAXWELL SOCCER CLUB
Organization’s Mailing Address 309 MAIN STREET
City MAXWELL
State IA
ZIP 50161-3000
Accounting period End 12
Primary contact name ADAM MESEKE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ADAM MESEKE
PRESIDENT
309 MAIN STREET
MAXWELL IA 50161-3016

Officer/Director/Trustee Two

ANNA TRAVIS
VICE PRESIDENT
14204 N 107TH AVENUE WEST
COLLINS IA 50055-1023

Officer/Director/Trustee Three

LAURIE MERRYMAN
TREASURER
1003 ROCK CREEK DRIVE
MAXWELL IA 50161-3016

Officer/Director/Trustee Four

JILL PETERS
SECRETARY
621 MAIN STREET
MAXWELL IA 50161-3000

Officer/Director/Trustee Five

KESHA CHRISTIE
REGISTRAR
208 1ST STREET
COLLINS IA 50055-1022

Organization’s website WWW.CMBSOCCER.ORG
Organization’s email CMBSOCCERINFO@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/26/2015
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N64 - Soccer Clubs, Leagues
Organization’s purpose Charitable: No
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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