FORM 1023-EZ for PRIMA TAPPA ATHLETIC CLUB INC

Field Data
EIN 81-2955059
Case Number EO-2016172-000092
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PRIMA TAPPA ATHLETIC CLUB INC
Organization’s Mailing Address 4140 FALLING WATER COURT
City FLOWERY BRANCH
State GA
ZIP 30542
Accounting period End 12
Primary contact name CHAD HAYES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CHAD HAYES
EXECUTIVE DIRECTOR
4140 FALLING WATER CT
FLOWERY BRANCH GA 30542

Officer/Director/Trustee Two

SEAN PHILYAW
TREASURER
PO BOX 729
OAKWOOD GA 30566

Officer/Director/Trustee Three

LISA HAYES
SECRETARY
4140 FALLING WATER CT
FLOWERY BRANCH GA 30542

Organization’s website WWW.PRIMATAPPA.COM
Organization’s email PRIMATAPPACYCLING@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/29/2016
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: No
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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