FORM 1023-EZ for GREEN BAY YOUTH LACROSSE

Field Data
EIN 82-3169138
Case Number EO-2017298-000488
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name GREEN BAY YOUTH LACROSSE
Organization’s Mailing Address PO BOX 10096
City GREEN BAY
State WI
ZIP 54307
Accounting period End 12
Primary contact name RUSTY BROWN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RUSTY BROWN
PRESIDENT
3220 DEVROY LN
GREEN BAY WI 54313

Officer/Director/Trustee Two

JASON CHAPLIN
VICE PRESIDENT
2636 MOOSE CREEK TRAIL
SUAMICO WI 54313

Officer/Director/Trustee Three

MISTY NAGAN
SECRETARY
1219 MEADOWVIEW LN
DE PERE WI 54115

Organization’s website WWW.GBYOUTHLAX.COM
Organization’s email GBLAX.TREAS@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/6/2017
Organization Incorporation State WI
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 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
Signature Title
Signature Date

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