FORM 1023-EZ for XTREME BALLERZ BASKETBALL CLUB

Field Data
EIN 81-2804744
Case Number EO-2016210-000637
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name XTREME BALLERZ BASKETBALL CLUB
Organization’s Mailing Address 9917 ZIRCON DR SW
City LAKEWOOD
State WA
ZIP 98498
Accounting period End 1
Primary contact name LASHAWN WILLIAMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LASHAWN WILLIAMS
DIRECTOR
9917 ZIRCON DR SW
LAKEWOOD WA 98498

Officer/Director/Trustee Two

JESENIA WILLIAMS
DIRECTOR
9917 ZIRCON DR SW
LAKEWOOD WA 98498

Organization’s website
Organization’s email WESTCOASTWILLOFCALI@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/29/2014
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, N.E.C.
Organization’s purpose Charitable: No
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 Yes
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
Signature Title
Signature Date

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