FORM 1023-EZ for SYNERGY FC AZ

Field Data
EIN 85-3514147
Case Number EO-2020296-000842
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SYNERGY FC AZ
Organization’s Mailing Address 26897 N 91ST DR
City PEORIA
State AZ
ZIP 85383
Accounting period End 12
Primary contact name REBECCA M UHL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CARRIE BALIAN
CHAIRMAN OF THE BOARD OF DIRECTORS
26897 N 91ST DR
PEORIA AZ 85383

Officer/Director/Trustee Two

DANIELLE GUTIERREZ
DIRECTOR
7604 W LOCKLAND CT
PEORIA AZ 85382

Officer/Director/Trustee Three

MIKE MARMON
DIRECTOR
9589 W HARMONY LN
PEORIA AZ 85382

Officer/Director/Trustee Four

REBECCA UHL
DIRECTOR
4622 W WAGONER RD
GLENDALE AZ 85308

Organization’s website www.synergyfcaz.com
Organization’s email synergyfcaz@hotmail.com
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/24/2020
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 Yes
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 REBECCA UHL
Signature Title DIRECTOR
Signature Date 10/19/2020

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