FORM 1023-EZ for PLAY ON LACROSSE

Field Data
EIN 47-3573545
Case Number EO-2017080-000156
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PLAY ON LACROSSE
Organization’s Mailing Address 3703 9TH ST CT NE
City HICKORY
State NC
ZIP 28601
Accounting period End 12
Primary contact name GINA MYERS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SCOTT CHARLES
PRESIDENT
3703 9TH ST CT NE
HICKORY NC 28601

Officer/Director/Trustee Two

JAY MCFARLAND
TREASURER
607 46TH AVE DR NE
HICKORY NC 28601

Officer/Director/Trustee Three

RONNIE HAINOR
AT-LARGE
951 44TH AVE CT NE
HICKORY NC 28601

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/6/2015
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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