FORM 1023-EZ for PANTHER QUARTERBACK CLUB INC

Field Data
EIN 87-0867417
Case Number EO-2021223-000425
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PANTHER QUARTERBACK CLUB INC
Organization’s Mailing Address 1455 OLD PARK ROAD
City VILLE PLATTE
State LA
ZIP 70586
Accounting period End 6
Primary contact name JASON J FONTENOT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MILFORD MILLER
PRESIDENT
7607 HIGHWAY 167 NORTH
VILLE PLATTE LA 70586

Officer/Director/Trustee Two

JOHN VIDRINE
VICE PRESIDENT
1747 OLD PARK ROAD
VILLE PLATTE LA 70586

Officer/Director/Trustee Three

BRIAN ARDOIN
SECRETARY
2675 PINE POINT ROAD
VILLE PLATTE LA 70586

Officer/Director/Trustee Four

JASON FONTENOT
TREASURER
1455 OLD PARK ROAD
VILLE PLATTE LA 70586

Organization’s website
Organization’s email PANTHERPRIDE70576@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/28/2021
Organization Incorporation State LA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B11 - Single Organization Support
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 JASON FONTENOT
Signature Title TREASURER
Signature Date 8/9/2021

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