FORM 1023-EZ for AQUA DE LA ROCA

Field Data
EIN 83-3562981
Case Number EO-2019052-000266
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name AQUA DE LA ROCA
Organization’s Mailing Address 1214 SPEARPOINT DR
City HENDERSONVILLE
State TN
ZIP 37075
Accounting period End 12
Primary contact name SCOTT MUELLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SCOTT MUELLER
PRESIDENT, DIRECTOR
1214 SPEARPOINT DR
HENDERSONVILLE TN 37075

Officer/Director/Trustee Two

JANEL MUELLER
SECRETARY, DIRECTOR
1214 SPEARPOINT DR
HENDERSONVILLE TN 37075

Officer/Director/Trustee Three

DALE HUELSMANN
TREASURER, DIRECTOR
18106 JAMES TOWN RD
BREESE IL 62230

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/11/19
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
Organization’s purpose Charitable: Yes
Religious: Yes
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 Yes
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 SCOTT MUELLER
Signature Title PRESIDENT, DIRECTOR
Signature Date 2/19/19

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