FORM 1023-EZ for ELIZABETHTOWN PANTHER LACROSSE

Field Data
EIN 81-4981980
Case Number EO-2017020-000335
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ELIZABETHTOWN PANTHER LACROSSE
Organization’s Mailing Address 1105 MARY T MEAGHER DRIVE
City ELIZABETHTOWN
State KY
ZIP 42701
Accounting period End 12
Primary contact name JAMES HARGAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAMES HARGAN
DIRECTOR
119 DANA WAY
VINE GROVE KY 40175

Officer/Director/Trustee Two

JESS BRYANT
DIRECTOR
20 CANARY DRIVE
ELIZABETHTOWN KY 42701

Officer/Director/Trustee Three

DUANE KRISTENSEN
DIRECTOR
334 EMMAUS CIRCLE
ELIZABETHTOWN KY 42701

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/9/2016
Organization Incorporation State KY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N11 - Single Organization Support
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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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