FORM 1023-EZ for ADAPTIVE SPORTS AWARENESS INC

Field Data
EIN 47-4760088
Case Number EO-2016133-000152
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ADAPTIVE SPORTS AWARENESS INC
Organization’s Mailing Address 251 MANNING STREET
City HUDSON
State MA
ZIP 01749
Accounting period End 12
Primary contact name BRIAN FARRELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MARK ANKETELL
PRESIDENT
251 MANNING STREET
HUDSON MA 01749

Officer/Director/Trustee Two

BRIAN FARRELL
TREASURER
17 FORBES
HUDSON MA 01749

Officer/Director/Trustee Three

MARGARET ANKETELL
CLERK
251 MANNING STREET
HUDSON MA 01749

Organization’s website HTTP://ADAPTIVESPORTSAWARENESS.ORG/
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/9/2015
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N01 - Alliance/Advocacy Organizations
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 Yes
One Third Support Gifts No
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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