FORM 1023-EZ for RAIDER ATHLETIC CLUB

Field Data
EIN 26-3483339
Case Number EO-2015027-000218
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name RAIDER ATHLETIC CLUB
Organization’s Mailing Address PO BOX 393
City SPENCER
State WV
ZIP 25276
Accounting period End 6
Primary contact name CONSUELO ESPARZA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JAMIE BURNSIDE
PRESIDENT
49 STEELE HOLLOW RD
SPENCER WV 25276

Officer/Director/Trustee Two

CONSUELO ESPARZA
VICE PRESIDENT
458 LAUREL ROAD
SPENCER WV 25276

Officer/Director/Trustee Three

LAURA KOVACH
TREASURER
109 PARK AVENUE
SPENCER WV 25276

Officer/Director/Trustee Four

MICHELLE BUTLER
SECRETARY
1685 RIPLEY ROAD
SPENCER WV 25276

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/6/2009
Organization Incorporation State WV
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N40 - Sports Training Facilities, Agencies
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 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 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
Signature Title
Signature Date

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