FORM 1023-EZ for ELMIRA SMALL FRY

Field Data
EIN 80-0589550
Case Number EO-2017069-000259
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ELMIRA SMALL FRY
Organization’s Mailing Address C/O FRONTLINE 1205 W CHURCH ST
City ELMIRA
State NY
ZIP 14905
Accounting period End 12
Primary contact name RANDALL JACKSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RANDALL JACKSON
PRESIDENT
117 DAFFODIL DR
HORSEHEADS NY 14845-1805

Officer/Director/Trustee Two

JIMMY JONES
VICE PRESIDENT
268 W 13TH ST OAKWOOD TERR APT B-8
ELMIRA NY 14903

Officer/Director/Trustee Three

DAVID JACKSON
TREASURER
602 YALE ST
ELMIRA NY 14904-2642

Officer/Director/Trustee Four

BRENDON BUCK
SECRETARY
317 ELM ST
ELMIRA NY 14901-2609

Organization’s website
Organization’s email BRENDON.M.BUCK@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/23/2010
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N99 - Recreation, Sports, Leisure, Athletics N.E.C.
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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