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        <AddressLine1>555 MASON ST STE 200</AddressLine1>
        <City>VACAVILLE</City>
        <State>CA</State>
        <ZIPCode>95688</ZIPCode>
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        <BusinessNameLine1>VACAVILLE SENIOR CITIZENS CLUB</BusinessNameLine1>
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        <AddressLine1>91 TOWN SQUARE PLACE</AddressLine1>
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        <State>CA</State>
        <ZIPCode>95688</ZIPCode>
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      <PersonNm>GERALD GORLEY</PersonNm>
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      <SignatureDt>2014-10-02</SignatureDt>
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      <PreparerPersonNm>TERESA FITZGERALD CPA</PreparerPersonNm>
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    <TaxYr>2013</TaxYr>
    <BuildTS>2015-11-30 17:44:51Z</BuildTS>
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      <MethodOfAccountingCashInd>X</MethodOfAccountingCashInd>
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      <CostOfGoodsSoldAmt>0</CostOfGoodsSoldAmt>
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      <PrimaryExemptPurposeTxt>THE PURPOSE OF THIS CLUB IS TO DEVELOP FRIENDSHIPS AND FOSTER A NETWORK OF FRIENDSHIPS FOR OUR SENIOR CITIZENS.</PrimaryExemptPurposeTxt>
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        <PersonNm>GENE MARTIN</PersonNm>
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          <State>CA</State>
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      <ForeignFinancialAccountInd>false</ForeignFinancialAccountInd>
      <ForeignOfficeInd>false</ForeignOfficeInd>
      <DonorAdvisedFndsInd>false</DonorAdvisedFndsInd>
      <OperateHospitalInd>false</OperateHospitalInd>
      <TanningServicesProvidedInd>false</TanningServicesProvidedInd>
      <Form720FiledInd>false</Form720FiledInd>
      <RelatedOrganizationCtrlEntInd>false</RelatedOrganizationCtrlEntInd>
      <TransactionWithControlEntInd>false</TransactionWithControlEntInd>
      <PoliticalCampaignActyInd>false</PoliticalCampaignActyInd>
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        <ExplanationTxt>Insurance $1024</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Other Expenses.1</FormAndLineReferenceDesc>
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