FORM 1023-EZ for SELINSGROVE SYNERGY SOFTBALL

Field Data
EIN 84-2814508
Case Number EO-2019277-000591
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SELINSGROVE SYNERGY SOFTBALL
Organization’s Mailing Address 2 N RED MAPLE ST
City SELINSGROVE
State PA
ZIP 17870
Accounting period End 12
Primary contact name JASON KLOCK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JASON KLOCK
PRESIDENT
2 N RED MAPLE ST
SELINSGROVE PA 17870

Officer/Director/Trustee Two

MICHAEL BOTTS
VICE PRESIDENT
PO BOX 45
FREEBURG PA 17827-45

Officer/Director/Trustee Three

MARY KLOCK
TREASURER / SECRETARY
2 N RED MAPLE ST
SELINSGROVE PA 17870

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/1/19
Organization Incorporation State PA
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JASON KLOCK
Signature Title PRESIDENT
Signature Date 10/1/19

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