FORM 1023-EZ for DRUID LAKES YOUTH LACROSSE ASSOCIATION

Field Data
EIN 47-4377261
Case Number EO-2015357-000220
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DRUID LAKES YOUTH LACROSSE ASSOCIATION
Organization’s Mailing Address 1782 BRIARLAKE CIRCLE
City DECATUR
State GA
ZIP 30033
Accounting period End 12
Primary contact name IAN CARTER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DAWN TAYLOR
PRESIDENT
1874 CASTLEWAY LANE
ATLANTA GA 30345

Officer/Director/Trustee Two

IAN CARTER
VICE PRESIDENT
1782 BRIARLAKE CIRCLE
DECATUR GA 30033

Officer/Director/Trustee Three

DAVE FLANAGAN
SECRETARY
2861 PONDEROSA CIRCLE
DECATUR GA 30033

Officer/Director/Trustee Four

JOHN CLARKE
TREASURER
2856 COUNTRY SQUIRE LANE
DECATUR GA 30033

Officer/Director/Trustee Five

PATRICIA CORNWELL
PARENT REPRESENTATIVE
3166 VINE CIRCLE
DECATUR GA 30033

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/28/2015
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N99 - Recreation, Sports, Leisure, Athletics N.E.C.
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 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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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