FORM 1023-EZ for IMPACT FC

Field Data
EIN 82-3653106
Case Number EO-2018010-000215
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name IMPACT FC
Organization’s Mailing Address 107 MCARTHUR DRIVE
City TROY
State IL
ZIP 62294
Accounting period End 12
Primary contact name ERIC HEYEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ERIC HEYEN
TREASURER
107 MCARTHUR DRIVE
TROY IL 62294

Officer/Director/Trustee Two

JOSH MEYER
PRESIDENT
15 FOX HILL DRIVE
CARLINVILLE IL 62626

Officer/Director/Trustee Three

ERIK THORNTON
VICE PRESIDENT
1329 N 18TH AVE
LITCHFIELD IL 62056

Officer/Director/Trustee Four

TRAVIS MATTHEWS
VICE PRESIDENT
26124 WEST COUNTY LINE ROAD
WAGGONER IL 62572

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/27/17
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N64 - Soccer Clubs, Leagues
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 Yes
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 ERIC HEYEN
Signature Title TREASURER
Signature Date 1/8/18

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