FORM 1023-EZ for TRI-STATE SANDLOT

Field Data
EIN 83-1899094
Case Number EO-2019036-000442
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TRI-STATE SANDLOT
Organization’s Mailing Address 535 WILCOX STREET
City WARSAW
State IL
ZIP 62379
Accounting period End 12
Primary contact name TEA CAMERON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHAD ROCKHOLD
PRESIDENT
210 POLK STREET
WARSAW IL 62379

Officer/Director/Trustee Two

JOSH SMITH
VICE PRESIDENT
735 SOUTH 7TH STREET
WARSAW IL 62379

Officer/Director/Trustee Three

JUSTIN TODD
OFFICER
441 OAK STREET
HAMILTON IL 62341

Officer/Director/Trustee Four

TEA CAMERON
TREASURER/SECRETARY
535 WILCOX STREET
WARSAW IL 62379

Officer/Director/Trustee Five

TYLER BRUNS
OFFICER
270 SOUTH MARION
CARTHAGE IL 62321

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/1/18
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N63 - Baseball, Softball
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 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 TEA CAMERON
Signature Title TREASURER/SECRETARY
Signature Date 1/17/19

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