FORM 1023-EZ for EASTSIDE WARRIORS YOUTH BASEBALL CLUB

Field Data
EIN 82-2522400
Case Number EO-2017248-000372
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name EASTSIDE WARRIORS YOUTH BASEBALL CLUB
Organization’s Mailing Address PO BOX 167
City PATASKALA
State OH
ZIP 43062-0167
Accounting period End 7
Primary contact name ROXANNE LANG
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

THOMAS DYER
PRESIDENT
360 FORWARD PASS RD SW
PATASKALA OH 43062-8521

Officer/Director/Trustee Two

ROXANNE LANG
TREASURER
467 APPLE BLOSSOM RD SW
PATASKALA OH 43062-9112

Officer/Director/Trustee Three

JENNIFER JOHNSON
VICE PRESIDENT
176 GALA AVE
PATASKALA OH 43062-9672

Officer/Director/Trustee Four

JUSTINA LOTT
SECRETARY
107 ZACKARY DR
GRANVILLE OH 43023-9037

Officer/Director/Trustee Five

JASON MOYER
BOARD MEMBER
109 COVINGTON LN
PATASKALA OH 43062-7203

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/19/2017
Organization Incorporation State OH
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 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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