FORM 1023-EZ for LAKE HAVASU CITY BMX ASSOCIATION

Field Data
EIN 83-1220941
Case Number EO-2018200-000372
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LAKE HAVASU CITY BMX ASSOCIATION
Organization’s Mailing Address 7260 SARA PARKWAY B
City LAKE HAVASU CITY
State AZ
ZIP 86406
Accounting period End 12
Primary contact name SHAWN P LAWLESS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID MILLSAPS
PRESIDENT
4221 COLT DR
LAKE HAVASU CITY AZ 86404

Officer/Director/Trustee Two

JEFF CAMPBELL
VICE-PRESIDENT
2857 PONY DR
LAKE HAVASU CITY AZ 86406

Officer/Director/Trustee Three

JAMIE WELTE
SECRETARY
3000 DAYTONA AVE
LAKE HAVASU CITY AZ 86403

Officer/Director/Trustee Four

SHAWN LAWLESS
TREASURER
2605 AVALON PLACE
LAKE HAVASU CITY AZ 86404

Officer/Director/Trustee Five

HARY LEARY
TRACK OPERATOR
982 ROLLING HILLS DRIVE
LAKE HAVASU CITY AZ 86406

Organization’s website LHCBMX.ORG
Organization’s email ADMIN@LHCBMX.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/13/18
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 SHAWN LAWLESS
Signature Title TREASURER
Signature Date 7/16/18

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