FORM 1023-EZ for OLYMPIA LACROSSE CLUB

Field Data
EIN 47-2395855
Case Number EO-2016230-000387
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name OLYMPIA LACROSSE CLUB
Organization’s Mailing Address 2330 55TH AVE SE
City OLYMPIA
State WA
ZIP 98501
Accounting period End 9
Primary contact name ALBERT PUNTILLO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ALBERT PUNTILLO
PRESIDENT/REGISTERED AGENT
2330 55TH AVE SE
OLYMPIA WA 98501

Officer/Director/Trustee Two

WINSTON MCKENNA
VICE PRESIDENT
2411 OTIS ST SE
OLYMPIA WA 98501

Officer/Director/Trustee Three

LIBBY BOGGS
SECRETARY
4417 22ND AVE SE
LACEY WA 98503

Officer/Director/Trustee Four

MARK BLACKLOCK
TREASURER
3416 POLO CLUB LN SE
OLYMPIA WA 98501

Organization’s website HTTP://WWW.OLYMPIALACROSSE.ORG/
Organization’s email OLYMPIALACROSSECLUB@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/27/2014
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: 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 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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