FORM 1023-EZ for WEST SHAMOKIN YOUTH SOFTBALL

Field Data
EIN 82-1712284
Case Number EO-2017229-000354
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name WEST SHAMOKIN YOUTH SOFTBALL
Organization’s Mailing Address 247 SECOND STREET PO BOX 102
City YATESBORO
State PA
ZIP 16263
Accounting period End 12
Primary contact name KATHY KEIRN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JASON ELKIN
PRESIDENT
204 LOCUST STREET
RURAL VALLEY PA 16249

Officer/Director/Trustee Two

MICHAEL KEIRN
VICE PRESIDENT
1296 STATE RTE 28 AND 66
TEMPLETON PA 16259

Officer/Director/Trustee Three

ANNA LASLO
SECRETARY
247 SECOND STREET
YATESBORO PA 16263

Officer/Director/Trustee Four

AMANDA COON
TREASURER
369 KITTANNING AVENUE
DAYTON PA 16222

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/14/2017
Organization Incorporation State PA
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: 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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