FORM 1023-EZ for FORZA SOCCER CLUB OF NEW YORK INC

Field Data
EIN 47-5531977
Case Number EO-2019077-000632
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FORZA SOCCER CLUB OF NEW YORK INC
Organization’s Mailing Address 112 GREENAPPLE LN
City MINOA
State NY
ZIP 13116
Accounting period End 12
Primary contact name MATTHEW URYNIAK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TOM CHAVOUSTIE
PRESIDENT AND CEO
112 GREENAPPLE LN
MINOA NY 13116

Officer/Director/Trustee Two

JAMIE WILSON
VICE PRESIDENT AND COO
1348 POOLVILLE ROAD
POOLVILLE NY 13332

Officer/Director/Trustee Three

MATTHEW URYNIAK
SECRETARY/TREASURER
114 KENSINGTON HIGH ST
MINOA NY 13116

Organization’s website FORZASOCCERCLUB.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/8/15
Organization Incorporation State NY
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: 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 MATTHEW URYNIAK
Signature Title SECRETARY/TREASURER
Signature Date 3/15/19

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