FORM 1023-EZ for CLAYTON JAZZ FESTIVAL INC

Field Data
EIN 47-3745610
Case Number EO-2015299-000334
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CLAYTON JAZZ FESTIVAL INC
Organization’s Mailing Address 12305 MAJESTIC VIEW LANE
City CLAYTON
State NY
ZIP 13624
Accounting period End 12
Primary contact name BRUCE HODGE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

BRUCE HODGE
DIRECTOR
108 MANOR CIRCLE
JUPITER FL 33458

Officer/Director/Trustee Two

MARY HEYMAN
DIRECTOR
435 RIVERSIDE DRIVE
CLAYTON NY 13624

Officer/Director/Trustee Three

STEVE MUTUKU
DIRECTOR
2885 JUPITER PARK DRIVE STE 1600
JUPITER FL 33458

Organization’s website WWW.CLAYTONJAZZFEST.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/9/2015
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A60 - Performing Arts 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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